To keep your musculoskeletal system in top form, orthopedists say to do these six things.

By Maggie Puniewska
November 19, 2020
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Down the road, as we get older, we all expect to develop a few aches—maybe a shin twinge, creaky elbows, or a sore lower back. But what if you could head off those problems, starting today? Your 30s, 40s, and 50s are a window of opportunity to course-correct any unhelpful habits that hurt your musculoskeletal health, says Melody Hrubes, MD, a sports medicine specialist at the Rothman Orthopaedic Institute in New York City. “If you make adjustments now, you can avoid surgery and set yourself up for more pain-free days later on.” Here is a series of simple steps you can take to protect your musculoskeletal system—your bones, muscles, ligaments, tendons, and joints—for years to come.

Bolster Your Frame

Every human body is held up by some 206 bones, but women have to be a little more mindful of theirs. We tend to have lower bone density than men in general. And during menopause, we experience a drop in bone density, thanks to waning estrogen, which is a key contributor to bone-cell production, says Sonu Ahluwalia, MD, clinical chief of orthopaedic surgery at Cedars Sinai Medical Center in Los Angeles.

One of the best ways to shore up your skeleton is to choose a diet that includes plenty of calcium and vitamin D, two nutrients essential to strengthening bone tissue. (Canned salmon is an excellent source of both!) The other crucial move: engaging in weight-bearing exercise—like walking, running, or strength training—a few times a week. These workouts exert a force on your bones that stimulates them to produce new cells, says Dr. Ahluwalia.

It’s also important to get a bone-density test at some point, to check for weaknesses. Doctors typically suggest women wait until age 65, but you may want to get a scan earlier if you’ve already had more than one fracture, or if you have a condition like inflammatory bowel disease, which can prevent nutrients from reaching your bones.

Listen to Cues

Working out is vital for so many aspects of your health—just keep in mind, it’s also a major culprit of musculoskeletal damage. “Injuries from physical activity either come from doing too much too soon, or not having the correct form,” Dr. Hrubes says. And these exercise injuries can lead to serious issues: They’re one of the top reasons people under 50 need orthopedic surgery, she adds.

To avoid sitting on the sidelines, pay attention to your body’s physical signals. Don’t brush off tenderness or push through discomfort. Minor aches should resolve within two weeks, but if they don’t, or you’re feeling numbness, tingling, or you are having trouble walking, bring up your pain or tightness to a trainer or orthopedist ASAP, urges Dr. Hrubes. A fitness professional or doctor can help you adjust your routine or technique so you give your tissues a chance to heal.

It’s also important to mix up your workouts, says Dr. Hrubes. If you’re a runner, for example, try incorporating a few days of yoga or swimming into your weekly regimen. Getting a variety of forms of exercise will help you target different muscles and ligaments, and prevent overuse injuries.

Lay Off the Ice

When you have a slight sprain or you think you pulled a muscle, there’s a good chance you’ll head to the freezer for a bag of peas. For many years, the standard advice for minor injuries has been RICE—rest, ice, compression, and elevation. But it turns out ice isn’t always beneficial and can sometimes be harmful. While ice can ease pain within the first 24 to 48 hours, it may delay healing. “It constricts blood vessels, which slows down the inflammatory response,” says Dr. Ahluwalia. Swelling is actually part of the recovery process, as the body increases blood flow and sends white blood cells and fluid to the damaged area in an attempt to repair it.

Slipping on a compression sock or sleeve can help; it’ll squeeze any built-up fluid out of the area. And most docs recommend engaging in gentle movement to prevent your tissues from stiffening up.

Another common mistake is icing sore legs or arms after an intense sweat session, says Dr. Hrubes. “Soreness means your body is repairing the micro-tearsin the muscles and building them back stronger.” A foam roller can help by loosening up tight tissue and improving blood flow to the area. Don’t have a foam roller? Try rolling a lacrosse or tennis ball over your sore spots instead.

Believe in PT

If musculoskeletal pain crops up somewhere in your body and you end up in a doctor’s office, you may be given a choice between drugs (such as painkillers or steroids), surgery, and physical therapy. Many orthopedists recommend trying the latter first: PT helps strengthen the area that’s causing your discomfort and corrects any imbalances that may be contributing to the problem. The therapy may even build up your resilience, says Dr. Ahluwalia: “It could reeducate your central nervous system to be less sensitive to pain signals.” 

Dr. Ahluwalia says he suggests PT to 90 percent of his patients. And there’s plenty of research to support his rec: A study published this year in The New England Journal of Medicine, for example, found that people with knee osteoarthritis who received physical therapy sessions had less pain and better physical function than those who received steroid injections.

In some cases, medication may be necessary, but combining it with a PT regimen might boost healing further. Korean researchers found that when people with a frozen shoulder took anti-inflammatory drugs or received steroid injections, both remedies worked better when the study participants were also doing PT.

Consider the Pelvic Floor

Back pain is one of the most common musculoskeletal issues, and also one of the most frustrating. There are a variety of possible causes—including a herniated disc, compressed nerves, poor posture, even weak glutes. But it’s worth considering yet another potential source that’s often overlooked: an imbalance in the pelvic floor, the group of muscles and connective tissues that stretch from your pubic bone to your tailbone.

“When the pelvic-floor muscles become too tight or weaken, they end up putting pressure on the back,” explains Dr. Hrubes. This discomfort often comes with other symptoms, such as painful sex, difficult bowel movements, and urinary incontinence.

Women who have been pregnant, or who have endometriosis or uterine cysts, are more prone to pelvic-floor issues. Lifting heavy weights can also put you at risk.

The good news for your aching back: A pelvic-floor specialist can help you rehab the problematic muscles. Most women are able to find relief with a combo of physical therapy and biofeedback therapy, says Dr. Hrubes.

Sit Right

Data from the CDC found that one in four American adults is seated for eight-plus hours a day. During the pandemic, many of us are spending even more time sitting at home. That could explain a lot about how your body feels: “Sitting in one position or with poor posture tightens up many of your muscles, ligaments, and joints, which often leads to soreness and pain,” says Dr. Hrubes.

Here’s how to manage all those hours on your bottom a little better. First, don’t attempt the 90-90-90 posture, with your knees, hips, and elbows all bent at 90 degrees. There’s actually no good evidence that that position is best, and it could result in joint stiffness, says Dr. Hrubes. Instead, she suggests leaning back a little in your chair so your hips are bent at an angle slightly greater than 90 degrees. Also, move your feet away from your body a bit so your knees are bent at a greater angle too.

If you’re not working at a desk, choose a stable seat that allows you to sit as upright as possible. A kitchen chair, for example, is better than the couch. And if the seat feels uncomfortable for your tush, invest in a gel cushion, which can help prevent soreness and the loss of blood flow caused by some hard surfaces, says Dr. Hrubes. 

Then, every 20 to 30 minutes, get up. The idea is to alternate between sitting and standing. When you’re on two feet, take a short walk, or try hip, neck, and shoulder rolls—and enjoy the stretch. 

This article originally appeared in the December 2020 issue of Health Magazine. Click here to subscribe today!

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Health December 2020