Haven't Got Time For The Pain

Middle age is fraught with ironies. For example, there's the way we need to exercise harder in order to maintain fitness at the same time as our bodies start hurting from years of use. Joints are weary, backs ache, muscles have been there, done that. It's not the kind of pain Jane Fonda talked about. Our muscles and joints can't always keep up with our determination to maintain the fitness habits of our youth.

Not that age is a prerequisite for joint and muscle pain. Injuries, poor training habits or even genetic luck can play a role in painful workouts, at any age. But as we reach our 40s and 50s, the stakes get higher. Overdoing a particular exercise routine can wear down already wearing joints and increase the risk of torn ligaments and inflammation at a time when we might not mend as quickly as we once did. Whether you're a longtime hardbody or an on-and-off fitness dabbler, your fitness program might need adjustment as you age.

For many years, Barbara Crummins, a 44-year-old graphic designer in Seattle, got her cardio workout at twice-weekly African dance classes. "It was really good exercise and it was fun - very energizing," she says.

But one day, about six years ago, Crummins made a leap in class, and when she came down, "I felt this crunch," she says. "I didn't think a lot of it when it happened, but the next day, I couldn't get out of bed. I couldn't put any weight on my leg."

Crummins had torn the cartilage in her knee, a common injury for people in or nearing their 40s, her doctor told her. Crummins decided against knee surgery, so the one bad landing required she wear a knee brace for about 10 months, as well as a month of physical therapy and 15-minutes of knee-strengthening exercises three times a day for about three months. "My knee hurt for a good six months," she says. The injury put an end to her African dancing and other activities. "I won't get on skis again as long as I live," Crummins says. "No way." Even high heels can be problematic. "I don't wear them much, but sometimes I do and go dancing, and the next day I have to ice my knee down." Crummins continues to focus on knee-strengthening exercises at the gym. She has started hiking again, although she has not yet tried backpacking since the injury and she's changed dance classes. "I do low-impact salsa dancing now."

Another risk as we age is getting so stuck in our fitness ruts, our routines become ineffective.

"I'm 51 and I've been working out for a couple of decades," says Steve Jacob of Grapevine, Texas, who plays tennis regularly and lifts weights. "I've been doing the same routine for a number of years. I'd keep reading that you need variety, but I wasn't inclined to do it alone." So Jacob, a newspaper publisher, hired personal trainer Kay Cross of North Richland Hills, Texas to design a new regimen for him every 10 weeks.
Cross says that when Jacob came to her, he had been working the same muscles in the same way for so long, he wasn't getting any fitter for his effort. In addition, she says, he had some tendonitis in his elbow. She redesigned his routine to include more variety, more sets and repetitions and to take some strain off his elbow joints.

"The thing people really need to realize is that even if they have an injury, they don't have to stop exercising. There's a million things you can do to work around an injury," Cross says.

Jacob found that his refreshed routines didn't mean working harder, but they nonetheless boosted his fitness level.

"At first, I thought these are pretty puny exercises and they're not going to get it done for me. But the first time I did a new routine, I got extremely sore," Jacob says. "Obviously, this gets me out of my groove and probably, ultimately, will get me in a whole lot better shape."

In fact, says Scott McLain, director of personal training at the Westerville Athletic Club in Ohio, a fitness rut not only interferes with optimal fitness, it can work against you. McLain says he often sees people who have spent too many years working out "vanity muscles" - the ones they can see in the mirror.

"Aches and pains are often caused because the muscles aren't in balance." McLain says. "I know people who have been teaching abs classes for 20 years and if you look at them from the side, they're in a permanent crunch. And a lot of people have rounded shoulders because the muscles in the front are overworked."

Whatever your age, the first step to a pain-free workout with less chance of injury is a balanced regimen, not only between cardio and strength training but also within them. For every crunch, a back extension; for every quad, a hamstring. You might not need to sacrifice your favorite Spinning or step class altogether, but you will feel better if you vary your class mix. "Stepping itself is not bad for the knees, but a lot of people who do step classes get addicted to it and they're doing it five or six times a week," says McLain. A little step, a little Spinning, maybe some yoga, and you'll be saving overworked joints and muscles.

Allen Jacobs, 48-year-old president of a management consulting firm in Dallas, Texas, found that too much running was among his problems.

"I got sore, especially in my lower back, from running and from lifting weights A few times, the lower back pain was so bad, I could hardly walk. I also injured my knee in some soccer games, and I was beginning to get sore more often from jogging."

Now, Jacobs does a lot more stretching than he used to, and he particularly likes hanging upside down, using inversion boots and rack ("My kids call me the 'bat dad,'" he says). He gave up running and instead mountain bikes with his teenage son Alec.

But if you can't bear to give up running, try taking your jog to the elliptical trainer, suggests Kori Kim, a certified personal trainer at 24 Hour Fitness in Canyon Country, California. "I prefer that to the treadmill because there's no impact. It goes so much smoother and your legs can move at a faster pace. If you go at that pace on the treadmill, that's running and it's hard on the joints."

Bike machines also can be a good substitute for running, but opt for the upright over the recumbent. People with knee and back pain are often attracted to recumbent bicycles, which are frequently used for rehabilitation after knee surgery, but McLain say, "On the recumbent, people tend to want to sit back and read a magazine. I prefer to see them on the upright because it requires core muscles," he says.

Core muscles-abs, low back and all the muscles that join your rib cage to your pelvis-are big players in balance, form, and injury prevention, and the reason personal trainers are slipping yoga and Pilates moves into even macho clients' workouts. Strengthening core muscles can be particularly helpful for easing or preventing lower back pain. Back extensions, done by lying on your stomach and lifting and lowering the upper body, are key to a strong lower back. Kim encourages her clients to do these low-tech extensions rather than using back extension machines, which people tend to load with too much weight, she says.

A lower back that has been neglected and is weak might object even to walking on a treadmill. If that's the case, Cross says, keep the treadmill off the incline setting and on the flat. Outdoor walkers who can't avoid hills should be particularly conscious of spinal posture. "People tend to get sloppy with their posture when they're walking on an incline," Cross says. "And you don't have to go as fast on an incline."

Shoulders are another delicate area, particularly since a shoulder injury can take a long time to heal. "We're talking months," says Cross, who suggests that instead of flies and pushups, people with shoulder injuries do bench presses, letting elbows drop to no lower than shoulder level. A modified standing pushup, done using a surface such as a bathroom countertop, with arms wide and feet about three feet from the counter, also is a reasonable substitute,

And of course, in all you do, use common sense and know your own limitations and how they might change with time. Use lighter weights for more repetitions, and don't be stubborn about slowing down when things start hurting. "It's all relative," says McLain. "Tae Bo is going to be great for some people, terrible for others. You just need to be able to accomplish a class pain-free. If you can't, you need to go back a step."

Now in his late 30s, McLain says he doesn't lift what he once could but he doesn't worry about it. "I can't max bench-press what I did at 25, but I'm still in good shape."