pamf.org

PAMF Health Blog

Be Well, Be Well Informed

Got Muscles? Don’t Let Sarcopenia Sneak Up On You

Posted on Jan 24, 2013 | 18 comments

Sarcopenia is derived from the Greek meaning “poverty of flesh.”  In medical terms it means the age-related decline in muscle mass which is typically at a rate of 0.5-1 percent muscle loss each year after age 25. This slow atrophy of our muscles is subtle enough that it may not be cause for immediate attention, but eventually it leads to early muscle fatigue, problems with balance, and increased sports injuries, since we lose our supportive muscles when we try to perform exercises and activities that require more agility (skiing, snowboarding, dancing, basketball, etc.).  

Have you noticed how you or your parents walk now compared to earlier in life? People become less sure-footed, they may walk with their legs a little wider apart to provide more support, and eventually the use of canes and walkers may be necessary. Many elderly people who fall frequently are a victim of age-related sarcopenia.  

Sedentary Muscle Fatigue

Another common type of sarcopenia is something I call “sedentary sarcopenia.” This is where prolonged sitting has led to significant muscle weakness in virtually every major muscle group. Many of my young software engineer patients tell me that even though they can walk for long distances and work out on an elliptical (stair climbing machine), as soon as they try to climb stairs they get completely out of breath. Sure, some of this is attributed to being aerobically out of shape, but many of us overlook the fact that weaker leg muscles cause fatigue earlier, so we breathe harder, our heart beats faster, and we struggle to move on. 

The “Turtle” Effect

The effect of being too sedentary on our upper body muscles is often overlooked. Take a look around you and see how many “turtles” you can spot.  I call “turtles” individuals whose heads protrude significantly forward from their spines.  It’s a result of hunching forward towards computer screens and the collapse and atrophy of upper back musculature that leads to this type of posture.  This is typically the hunchback posture I would expect to see in my very elderly patients with osteoporosis (a disease where the bones become weak and can easily break), but now I’m seeing it in my young “mouse potatoes.”

Are You a “Mouse Potato?”

I can almost predict how many hours you spend at the computer based on how far your head has shifted forward.  A physical therapist told me that for every inch your head moves forward from your spine, your neck has to support 10 more pounds of weight! This is a major cause of neck pain, shoulder pain and tension headaches. I’ll never forget seeing a 30-year-old computer engineer who came into the doctor’s office after a car accident, carrying in an X-ray of his neck taken at a local hospital. Fortunately, there were no fractures, but what really stood out to me was that his neck already showed signs of the type of degenerative arthritis I would expect in a 60-year-old patient!  

What Can You do to Slow Down the Effects?

My greatest fear is the cumulative effect of sedentary and age-related sarcopenia and what that will lead to as we encounter a new generation of seniors who come from a high-tech lifestyle.  So, what can you do to slow down the effects of sarcopenia?

1.         Lift weights no matter what your age: I’ve noticed that as most of my patients age, they do more cardio and less weights. From what you’ve learned in this blog post so far, you must maintain weight training as a core part of your workout regimen.  If you do circuit training, where you take minimal rest periods between sets, you can combine the benefits of strength training and aerobic by maintaining an elevated heart rate. 

2.         More free weights, less machines: Weight machines have evolved into comfortable, cushioned benches which provide maximal support while you push weights up and down or forward and backward. Machines work very isolated muscle groups and do not challenge your sense of balance or sense of orientation.  These are senses you need if you want to maintain a steady gait as you age, and prevent injuries as you engage in activities and sports that require agility.  Lifting free weights like dumbbells and kettlebells or incorporating more challenging body weight exercises like yoga, will keep your balance centers in check.  The good news is that these types of exercises can be done outdoors or in the comfort of your own home. 

3.         Avoid being a turtle: Move closer to your desktop and steering wheel so you’re not hunched forward while working and driving.  Be posture-conscious in all of your activities.  Try standing more and consider a standing workstation at home and work. Useful posture thoughts are thinking of your head crowning your spine and keeping those shoulders back.  Of course this is tough to do if you’ve got weak upper back muscles, so strengthening these muscles by lifting weights will help you maintain your posture and prevent you from joining an ever growing squadron of turtles. 

And above all…remember to be strong, be well-balanced, and walk with your head held proudly above your spine!

 

Ronesh (Ron) Sinha, M.D.

This blog post is contributed by Ronesh (Ron) Sinha, M.D., Palo Alto Medical Foundation Internal Medicine. Dr. Sinha works closely with the South Asian community to help reduce heart disease and diabetes risk, and provides corporate health lectures to promote wellness in the workplace. Dr. Sinha holds clinical faculty positions at UCLA; Stanford University School of Medicine; and the UCSF School of Medicine. He teaches Stanford and UCSF medical students.

Please note that we are unable to respond to personal medical questions through the comments feature below. For information about personalized health care, or if you need help in choosing a PAMF physician, please visit Becoming a PAMF Patient (http://www.pamf.org/findadoctor) or call 1-888-398-5677. If you are a PAMF patient, you can email your doctor securely via our My Health Online program. Thank you

18 Comments

  1. I found this article very informative. I have been doing yoga and walking, but will now start free weights. Thanks for reminding me!!!

    • Great job on the yoga and walking. I sometimes like incorporating free weights into yoga. Using a kettlebell or dumbbell during some of the poses like triangle gives you an extra stretch and increases strength.

      • It would be helpful if you could post some specific exercises for the neck and upper back.
        Thank you.

  2. This is a great advice. Another benefit of building our muscles mass is that we burn more post exercise calories.

    • Completely agree! You will burn more post exercise calories and in particular some of that stubborn body fat. Thanks for adding that.

  3. Dr. Sinha,

    Thanks for the explanation and the remedies. I work with computer all day at work, and a lot at home too. Am almost 62 years old and I do notice the loss of muscle mass. Some is related to age and lack of exercise, and some is probably related to sarcopenia.

    I also have peripheral neuropathy in my feet, and have noticed that balance has become harder sometimes while standing or walking – especially when leaning forward while standing.

    I”ll do some free weights, as well as do some exercises that build strength in the muscles that help to maintain balance. Thanks again for the wake up call.

  4. Sounds like a great plan. Remember, even using body weight is a great way to add muscle. Doing air squats without any weights is an excellent way to add strength to your quadriceps (thigh muscles) and can be done anywhere, any time.

  5. Dr. Sinha – Thanks for the information. I do Iyengar Yoga and maintaining the poses has really helped my strength and my posture. I had a meniscus shave a couple of years ago, and altho I healed well, I still have some balance issues. I gather you think that using free weights would help with that. Any other thoughts?

  6. I am 70 and work out with my WII Fit for about an hour about 3 times a week. I start with about 15 minutes of yoga, then a variety of other balance and coordination exercises but none are very aerobic. I suppose I should do about 1/2 hour of brisk walking on some of the days i don””t use the WII. Thanks for the article.

  7. Dr. Sinha,

    Thanks for the wonderful article. I used to be on metformin and Lipitor. I used to bike and run. In the last couple of years, I lost a lot of muscle. I have experienced long recovery time and severe cramping after exercise. I believe these medications had something to do with these problems. I am currently off these medications, would you recommend weight training in my case?

    Obul

    • Hi Obul,

      I would definitely check with your doctor who is familiar with your medical history and should be able to clear you to start working out with weights.

      - Dr. Sinha

  8. Can you recommend a book with good photos that show exercises to do with free weights for upper and lower body? Thanks.

    • Hi Christine,

      Book Recommendation: 101 Ways to Work out with Weights, by Cindy Whitmarsh.

      I also suggest checking out online videos and I use a free app called “Fitness Buddy” which has nice short videos and allows you to log in your progress.

      - Dr. Sinha

      • I”m 97 and I need strength training and balance training. I will work with my physical therapist after his evaluation on me a week ago.

  9. I”m 79 and use 5 lb weights, 25 reps twice a day

  10. I am very concerned about loss of muscle mass. I am an avid tennis player and go to the gym twice a week to work out. In spite of that I continue to lose muscle mass. Is there anything that can be done with nutrition to minimize or reverse muscle mass loss? Can you recommend relevant books or other information source?

    • Thanks for your question Ray. From a lifestyle perspective, adding more weight training sessions and increasing the amount of healthy protein in your diet may help. A personal trainer can help with this. If this continues or gets worse, I would make sure you consult with your physician to make sure there are no underlying medical or metabolic disorders that are causing more rapid muscle loss.

      - Dr. Sinha

  11. Weight training is a must to keep up tone and strength. I have been doing Crossfit training for three years and have seen great results in both my ability to life more weight and increase in my bone density. My balance has imporved and my quality of life with great energy is that of a much younger me. I am 67 yo and I can not agree more with Dr. Sinha that all people will benefit with strength training.

Leave a Reply

Your email address will not be published. Required fields are marked *

You may use these HTML tags and attributes: <a href="" title=""> <abbr title=""> <acronym title=""> <b> <blockquote cite=""> <cite> <code> <del datetime=""> <em> <i> <q cite=""> <strike> <strong>