Some of the most interesting information on the effects of aging and physiologic changes we may experience with aging is not widely known or disseminated. Most of us recognize that older people tend to be more prone to falls and injuries sustained from falling. We often focus on loss of balance and frailty as a cause, and spend time trying to figure out how to improve balance and make some sort of cushioning apparatus or “air-bags” or provide walkers, canes, and other implements to help with stability. Perhaps if we spent more time addressing the root cause of loss of balance and increasing frailty we might do a better job at preventing those severe injuries resulting in significantly worse quality of life for the injured person, along with an even shorter life expectancy following the injury.

Aging tends to cause a loss of muscle mass. Did you know that there are two basic types of skeletal muscle? One type of muscle, called “slow-twitch”, provides greater strength, reacts more slowly to nerve signals but tends to be able to contract longer. That muscle tends to be preserved with aging to provide core stability and allow basic needs such as breathing and daily living activities to proceed. The other type of muscle is “fast-twitch”, which provides fast reaction time, responds quickly and contracts very quickly with nerve signals. If you stub your toe on the floor and lurch forward, it is the fast twitch muscle that allows you to move that leg forward to stop your fall. Fast twitch muscle allows a rapid response to a situation, something we think of as “reflexes” because the movements occur so quickly in response to an urgent physical situation. Falling is not just about a loss of the balance mechanism in the inner ear. Although that system can certainly be damaged and may function more poorly with aging, it is not typically the real culprit in most falls. Fast twitch muscle tends to be lost more quickly with aging because we tend to use it less as we age. Unless we practice a sport or other physical activity requiring regular sustained use of fast twitch muscles, we will tend to lose them as they gradually transform into slow-twitch muscles.

What are best practices for healthy aging when it comes to muscles? First, we need to get enough essential amino acids (proteins) to support and maintain good muscle mass and function. Making sure that you have a diet with adequate amino acid support is essential to maintaining strength and vigor. Second, we need to pay close attention to the proper types of exercise and activities that will support both slow- and fast-twitch muscle. Training for strength and speed are essential at every age. It is also important to remember that after an injury, rehabilitation needs to include attention to building and maintaining that fast-twitch muscle to help prevent future injuries.

We know weightlifting (of any type) can help with slow-twitch muscles. How do we build and maintain fast-twitch muscles? First, finding an exercise or activity requiring some type of explosive exertion. Fast sprints, tennis, just about any fast-moving sport, martial arts training, plyometrics training are all strategies to help build and maintain fast-twitch muscles. What about following a fall/injury? Some physical therapy sites actually have an apparatus that helps prevent falls from tripping by creating a harness system that supports an individual walking on a long treadmill. The treadmill is designed to cause the walker to trip and have to rapidly move a leg to prevent the fall. The harness prevents the walker from falling after the trip, so there is no risk of injury. However, after training on this apparatus, the fast twitch muscles are recruited in the legs to help speed up reaction time and increase the likelihood that a person will be able to prevent a fall from tripping. Naturally, it would be best if we could all start our training early and maintain it throughout life. However, it is never too late to start working on it. A well-qualified physical trainer can help with focusing on fast-twitch muscle training. A healthy lifespan, with a well-maintained healthspan, can be achieved first through proper diet and exercise. There is no substitute for those pillars. Proper supplements, along with some biologic response modifiers, may improve cell function and further slow the aging process. To learn more about healthy aging, call our office at 561-701-2841.

– Linda Kiley, MD