By the time you read this I will be 51 years old. I’ve just had a fifth operation on my right knee (the third within a year), ending any lingering hopes I had of making it in professional football.
But it’s not the only issue. I’ve also had two steroid injections in an arthritic hip and one for a frozen shoulder. I’ve had denervation of the nerves in the base of my back, and I take Naproxen for a stiff neck. One of my big toes doesn’t move much either.
Suddenly, that sense of invincibility I possessed in my 30s and early 40s, when I was still running around like I was 18, has vanished and any physical activity I’m asked to participate in generally requires a full risk assessment.
In an ideal world, I would have my knee and hip replaced but surgeons won’t consider it yet. It’s not often, at my age, that you’re annoyed when someone tells you you’re too young for something.
If you’re approaching 50, here are some of the problems that might be coming your way – and what you can do to manage, or stave them off.
Typically, fiftysomethings will suffer from a range of knee complaints, with bursitis, meniscal tears and osteoarthritis being the most common. “It’s an age thing and, for the most part, simple wear and tear,” says Mark Edmondson, a UK orthopaedic surgeon. “The shock absorbers in your knees tend to get dehydrated and more rigid with age and can be more easily damaged when put under normal stress.
“What starts with a localised pain and swelling of the joint will often develop into more mechanical symptoms where the knee gives way, buckles or just gets stuck when it’s bending.”
Long term, knee arthritis may require a knee replacement, be that partial or full. The average age of recipients is currently 70 years old, but improvements in technology are allowing for artificial knee joints to last longer, says Ananda Nanu of the Royal College of Surgeons. “Whereas 15 years ago it was common for a patient of 65 to be told they were too young for a knee replacement, it’s not the case now.”
What to do about it: “When pain starts to happen people often avoid the movement that causes it, but then the joint just gets weaker, which ultimately makes things worse,” says personal trainer Matt Roberts, who has coached David Cameron and celebrities such as Amanda Holden.
If you’re suffering with knee pain, Roberts advises spending 10 minutes a day doing gentle stretches, such as a sitting leg extension: Sit in a chair, straighten both legs, feel the quads tighten, then release, and repeat 20 times. If the pain is marginal, you could try sitting against a wall. For those without pain, step ups, lunges and squats help keep the area strong.
Throughout my life I’ve enjoyed 20/20 vision but in the last five years I’ve started wearing reading glasses. Idiotically, I’ve not been for another eye test in that time either, which now means I can’t read the really important things in life, like takeaway menus or instruction leaflets for power tools. Presbyopia – age-related long sightedness – is pretty unavoidable, even if, like me, you’ve never had any issue with sight before. Ageing causes the lens of the eye to harden and lose its elasticity.
What to do about it: “Presbyopia can be easily treated with glasses or contact lenses,” explains Daniel Hardiman-McCartney, of the College of Optometrists. “If you already wear glasses a switch to varifocals may be all that is needed.”
Regular visits to the optometrist are essential and a healthy diet, covering a rainbow of colours, can help reduce the risk of age-related macular degeneration. Wearing high UV sunglasses in the sun may help protect against cataracts.
Few things make you feel your age like a creaky, achy hip. The most common cause is osteoarthritis – the deterioration of cartilage leading to bone grinding on bone and painful inflammation. Along with ageing, genetics play a role, and obesity, too. It can also be caused by rheumatoid arthritis or arthritis caused by injury.
“By the time people get to their 50s, if they haven’t carried over problems in their hip from earlier on in their life then they can start to feel pain from early degenerative change,” says orthopaedic hip and knee surgeon Majid Chowdhry. “This can be felt as increased stiffness or difficulties with duration, frequency or intensity of exercise.”
What to do about it: Keep moving.
A 2019 study found arthritis sufferers can stave off disability with just a short walk of 10 minutes a day.
If you find yourself in pain even when resting, it’s possible you’ll need a hip replacement. The majority are carried out on patients between the ages of 60 and 80, as modern artificial hip joints are only designed to last 15 years.
Roberts recommends glute bridges to strengthen the core and improve hip mobility. Lying on your back, with your feet flat on the floor, lift your bottom up until you have fully extended your hips, and squeeze your glutes when you reach the top. Slowly come back down to the starting position and repeat.
Those in their 50s can face a perfect storm of stress-triggers, including divorce, demanding careers, caring responsibilities and physical health worries – and that was true before Covid.
What to do about it: Acknowledge how you’re feeling – depression can manifest as anger and irritability as well as withdrawal and despair – and talk to someone, whether it’s your GP or a trusted friend or partner.
Exercise, cutting back on alcohol or improving your diet have been proven to be effective for those with mild depression.
In more serious cases, cognitive behavioural therapy or antidepressant medications will help, says Dr Gary Howsam, vice-chairman of the Royal College of General Practitioners.
Roberts says his favourite exercise for stress busting is tennis. “It’s social, and it’s cardiovascular – it ticks all the boxes.”
Back pain is one of the biggest causes of working days lost, and tends to start between the ages of 40 and 60. Major causes include spinal stenosis where the spaces between your spine shrink, putting pressure on the nerves, spondylolisthesis – friction between the lower vertebrae and the bones beneath – and degenerative changes. All are related to ageing.
What to do about it: “Anti-inflammatory analgesics and/or some muscle relaxants might work in the short term but it’s a misconception that back pain can resolve itself,” says Dr Brian Hammond of BackCare.
Looking after your core is crucial for preventing back pain – and indeed all other joint pain, says Roberts. Try the bird/dog exercise – on your hands and knees, raise your left arm and right leg, then tuck them underneath you, and switch to raising your right arm and left leg.
“This strengthens the core and works well for the middle and lower back.”