Complications of exercise Part 3

 Musculoskeletal injuries – with moderate activity

Physically very active adults (not necessarily older adults) tend to experience a higher incidence of leisure-time and sport-related injuries than their less active counterparts. However, healthy adults who meet the usual governmental activity recommendations have an overall musculoskeletal injury rate that is not much different from that of inactive adults. Active men and women have a higher injury rate during sport and leisure-time activity, while inactive adults report more injuries during non-sport and non-leisure time. A possible reason for this lower injury incidence during non-leisure time is the increased fitness levels (endurance, strength, balance) of the more active adults.

Inevitably, more vigorous exercise with its greater benefits does bring a higher risk of musculoskeletal injuries as the intensity and amount of activity increases. However the benefits of a vigorous exercise regime greatly outweigh the temporary inconvenience and discomfort of these minor injuries. The common belief that it is exercise that causes chronic joint problems and osteoarthritis is wrong. Regular physical activity  reduces the risk of developing painful osteoarthritis by improving cartilage resilience and by increasing the strength of the muscles that support the joints.

High levels of walking are associated with reduced need for hip-replacement surgery and it has been found that cycling can be an effective way of delaying hip surgery. Activities such as jogging, that place greater strain on joints, appear to be more protective than lower-impact activities and it is a myth that recreational running leads to osteoarthritis of the knees.

Musculoskeletal injuries – with excessive activity

It is probably true, however, that excessive exercise such as that taken by ultra-marathon runners and the like may bring high levels of musculo-skeletal injury. A study of runners training for a half-marathon in Sweden found that one third suffered such problems during the year before the event. Half were related to knees, calves or Achilles tendons but were mostly minor and short lived. Surprisingly the incidence of injuries was not related to gender, age, BMI or running experience.

The long-term effects of strenuous exercise at international level may be greater. A study of 3,300 retired Olympians found that 63% reported at least one injury and about a third suffered ongoing pain and/or functional limitations.  Sports students, who often train for many hours per week, are also at risk of painful injuries with resulting psychological problems.

Musculoskeletal injuries – in older people

Studies on injuries in adults aged 65 and over are scarce. The rate of injuries occurring during physical activity in advanced age, based on existing data, is very low compared to other ages. Based on current available research, there is no substantial evidence to justify the fear of getting injured through purposeful physical activity or participation in sports in advanced age. Indeed, strengthening bones and improving balance by exercise training programmes reduces the risk of injurious falls in the elderly.

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