Repair Your Body's Wear and Tear

One day, it hit me. I was stunned by the things I could no longer do. I couldn't squat and come back up without putting my hand on a chair, or walk a mile without feeling excruciating, aching pain in my right hip. I couldn't bend over to play with my 6-year-old son. It was hard getting out of a chair. My hips seemed to freeze after a brief hike. Calisthenics had become a cruel ritual.

They call it wear and tear. After decades of Ironman contests, ski racing, cross-country skiing, kayaking, rowing, running, swimming, mountain climbing, you name it, I was worn and torn.

I'm not alone; we're all getting worn and torn faster and younger than ever before. Why? We're putting more of the wrong kind of strain on our joints at earlier ages. Many of us damage our joints by having weak and inflexible tendons and muscles and by being overweight. For others, it's because we push ourselves too hard in the wrong sports. "Disuse, misuse, and abuse" is fast becoming the slogan of our generation. The fact is, we're all getting worn and torn in bits and pieces starting in our 30s, though for some of us, the process may have begun in our teens. By age 40, the damage already shows up on our x-rays.

Fortunately, the damage can be undone, or at least minimized. You can beat wear and tear and become more supple, limber, flexible, and energetic than ever before so you can continue to play the sports you love—without pain. Remember, for most of us, wear and tear is part of aging. Wear and tear saps the important elements of our youth, leaving in their place creaky, groaning joints and tired, sore, inflexible muscles. I'm a little reluctant to mention arthritis, but that's where excessive wear and tear eventually leads.

We can help you detect the early warning signs before arthritis sets in. (When I use the word arthritis, I'm referring to wear-and-tear arthritis, which is also known as osteoarthritis.) What's the difference between wear and tear and arthritis? Wear and tear is pure mechanical damage. Arthritis occurs when this mechanical damage triggers chemical reactions within a joint that cause its destruction.

I didn't make much of my own aches and pains until I was asked to moderate a panel discussion at an arthritis meeting. A woman from the Arthritis Foundation came up to me and said, "You've got a limp! Do you have arthritis?"

Had I become one of them? Was I an arthritic? "Of course not," I protested. I tried to escape the watchful eye of former 49ers quarterback Joe Montana, the panel's special guest. "A little arthritis, Bob?" he asked. "No, no, no," I protested again. "I don't have arthritis." But Joe's unwavering look and practiced eye sure gave me second thoughts.

I considered it over the weekend and then called an orthopedic surgeon at the Hospital for Special Surgery in New York. After I reported to the hospital and stripped down to my shorts, he examined my knee. "Overloaded," he said. Then he looked at my hip. He maneuvered it until there was a painful clash of bone on bone.

He packed me off to the x-ray room. Sure enough, the film showed a joint already badly damaged. He advised me to give up skiing, tennis, and running—my favorite activities. I was given a series of modest exercises to do and sent packing. But nothing seemed to help. Traditional medicine would have nothing to offer until I was ready for joint replacement-no effective therapy, no medications, and no exercises to repair my damaged hip. I swore to myself, I'll be back, better than ever! Not as an Olympian or Super Bowl champ but as the ultimate weekend warrior of my youth.

I combed the scientific literature. I read every article in every journal. I visited the best labs and clinics in the country. I put together my own program with the help of dozens of top specialists.

The result: Now I've beaten wear and tear, and you can too. I feel and perform better than any time since my 20s. Within weeks of the arthritis meeting, I went from taking 12 Advil a day to none. I went from having to stumble down the aisle of a commuter airline to walking pain-free. I found I could play singles tennis again without the cruel dark ache I'd suffered from before. The leg spasms that had kept me awake at night are gone. I can jump off a precipice into the steepest couloir in Jackson Hole and surf the toughest onshore break at Bondi Beach-things I had wanted to do as a kid but never dared! Now, as a foreign television correspondent, I can put in grueling 22-hour days and outlast colleagues 20 years younger in such remote places as Afghanistan and Somalia.

I've learned that no effects of aging are more important to stave off than those that affect your muscles and joints because they bear the major brunt of wear and tear. As muscles become still and joints become sore and restricted in their range of motion-studies show that 50 percent of us are affected by the time we reach midlife, 85 percent by age 70-you actually begin to look and feel older.

There are many reasons why you're hurting, but I've listed the three major ones you'll want to address today. The accompanying strength and stretching workout, and information on the best supplements to take and exercises to perform, will also put you closer to being pain-free. It's the only way to live.

1. STIFF-MAN SYNDROME

The big birthday with a frightening "0" at the end had arrived. But I wasn't stiff and rickety from age; I was that way as a result of civilization. "Sitting in our cars, and at our desks with increasing computer use, leads to muscle shortening and muscle pulls," says Gary Brazina, M.D., a Los Angeles-based sports medicine doctor and a fellow of the American Academy of Orthopaedic Surgeons.

If we don't stretch our tendons and muscles, they get shorter and shorter, hampering our range of motion and putting stress on our joints. Tendons that aren't stretched regularly re-form thicker, as well. Just as the highway department pours new concrete to repair a road, the body lays down new collagen in tendons. When it pours the collagen into a shortened tendon, it reinforces that diminished tendon by making it thicker, limiting your range of motion.

Similarly, when muscles are not used, the body lays down new collagen in response to the lack of movement, according to David Z. Prince, M.D., director of cardiac rehabilitation at Montefiore Medical Center in the Bronx. Any unused muscle will become shortened, tight, and immobile, sometimes within days. Why? It's the body's way of stabilizing an inactive or underused joint.

As a result of these bodily reactions, we may initially mistake stiffness and pain in our joints, tendons, and muscles for arthritis. It's not, but the resulting awkward motion patterns this stiffness creates produces abnormal forces on the joints and eventually leads to the disease. Take the arthritic hip, for example. First there's pain, which emanates from the capsule that surrounds the joint. This pain inhibits normal muscle contractions, and the muscle becomes shorter and weaker. This is how even active people may gradually build up scar tissue in their muscles. And it's why stretching is the important first step to pain-free fitness. Gently and carefully pushing through the pain and maintaining the natural range of motion helps to avoid the consequences.

To put stretching back into your workout, nothing beats yoga. I've done it. Believe me: You'll notice the first changes within a week. Here's why yoga works:

The stretching delivers relief from the aches and pains of wear and tear.
It stabilizes your joints by strengthening and coordinating the small muscles that exert fine control over your joints, especially the hips, and by protecting them from jarring movements.
It builds balance and elasticity. This means that for any given load, the muscles involved can better absorb the shock in a shorter range of motion. Your posture, strength, and flexibility all improve.
Try the Proud Warrior (Triangle) Pose. It's the safest and most gentle way to open up your hips.

Stand with your feet slightly more than shoulder-width apart.
Begin with your arms at your sides; then move them directly up until they're parallel to the ground, as if you were making a spread eagle. Your palms should face downward.
Keep your left leg straight, and then point your right foot and leg off to the side at a 90-degree angle from your left foot.
Point your left foot outward at a 45-degree angle. Keep an equal amount of weight on both feet at all times, even though you may feel as though you're favoring your right side.
Finally, lower yourself by bending your right knee until your thigh is parallel to the ground. Turn your body so that your belly is brought around to face forward.

2. WEAK MUSCLES

Quadriceps weakness is one of the earliest symptoms reported by arthritis patients and often precedes the development of knee pain and disability. Amazingly, it's a better determinant of pain and disability than even x-ray changes.

As you probably know, we all lose muscle with age, beginning around 40. The decline in muscle strength from aging can be attributed to the loss of muscle mass and our muscles' capacity to generate force. This loss accelerates at age 50, and by age 80, we've lost approximately 40 percent of our total skeletal muscle mass. But much of this decline can be avoided with weight training.

None of this may seem startling to you, but it has been a revolution in thinking for doctors. "Everyone has been in the mindset that it's the joint damage that causes the muscle weakness," says Michael Hurley, Ph.D., an osteoarthritis and rehabilitation expert at Kings College in London. There had been little suspicion that the muscles weakened first, directly contributing to the onset and progression of arthritis.

So the next step for you will be to build new muscle to protect your joints, primarily your knee joints. Every man should do resistance training for his quadriceps, the muscles on the front of the thighs. Why? Quite simply, the quadriceps act as brakes. As your legs descend during a normal stride, the quadriceps slow the heels as they approach the ground. Once your heels hit dirt, your quadriceps are shock absorbers that dissipate potentially damaging forces before they hit the knee joints. With weakened quads, the load goes straight to your joints as your heels land on the pavement.

Strong quadriceps also function as stabilizers that guard against torque, shearing, and twisting forces on the knees. (Need any more reasons to do those squats and lunges?) Simply put, having strong quadriceps will allow you to be more active. And the more active you are, the more calories you can burn, which leads to the next issue.

3. OVERLOAD

Two-hundred-ten miserable pounds-ugh! It was the heaviest I'd ever been (a good 20 pounds over my regular weight), but then, that's what happens with wear and tear. Everything hurt: my knees, my hips, my shoulders. The more pain I had, the less activity I engaged in, and the pounds just kept piling on. I'd always heard that weight loss leads to a decrease in arthritis pain, but weight gain dramatically increases the pain.

How to get it off? The biggest problem is that painful joints make your best weapon, vigorous physical activity, tougher to do. The decrease in your ability to exercise without pain often results in even greater weight gain. This added weight is also potentially destructive. Doctors at the Baptist College of Health Sciences in Memphis found that obese people were destroying their knees, blowing them out with such severity that in some cases the only therapeutic choice was amputation! These people developed weakness of their quads, limited range of motion, and arthritis.

So, the third thing you have to do is crank up your calorie burn with aerobic exercise without doing any damage to your joints. Some of the best joint-friendly exercises are walking, bicycling, tai chi, cross-country skiing, rowing, using an elliptical trainer, and swimming. This last sport is extremely kind to the joints of your lower body. If you suffer from kneecap pain, try swimming with fins. Adding fins forces you to kick a little more straight-legged, so you won't put stress on your knee.

Attacking these three problem areas with a smart program of stretching, strengthening, and weight loss will help you feel dramatically better-just as I do-perhaps the best you've felt in decades. Get going.

Adapted from Wear and Tear by Dr. Bob Arnot (Simon & Schuster, 2003). Dr. Arnot is a special foreign correspondent for MSNBC.

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