I was lying on my side at physical therapy, halfway through a set of leg raises tostrengthen a butt muscle gone soft, when a therapist attending to a 41-year-old woman with knee pain said something that made my ears perk up.
“After they turn 40, they all come in here with lower-body problems,” she said, referring to us, the patients.
Until that moment, I hadn’t considered the possibility a perplexing parade of injuries I’d experienced since my 44th birthday – to my foot, my lower back, my hamstring, hip and elbow – was connected to my age. I do the kind of physical activity – high-intensity yoga, running and rowing – that should theoretically keep my whole body strong. Yet doctors and physical therapists kept telling me certain muscles were very weak, causing my other joints and muscles to overwork, leading to injury.
I stumbled into my 40s largely ignorant of the changes to come, not just to my muscles but also my hormone levels. We may be prepared for wrinkles and grey hair, but the decline in strength and increased risk of injury, even among very active people at this stage in life, is little recognised and rarely discussed.
Many people first notice muscle weakening and injuries in their 40s, even if they’re active. Photo / 123RF
New research shows the bodies of men and women may age in waves, with one significant acceleration in our mid-40s (and another in our early 60s). Acknowledging our 40s as a turning point can help demystify this era, allowing us to see it for what it is: a crucial time to counter some aspects of ageing and the more punishing health problems that could lie ahead.
Fortunately, there’s good science on how to do that, specifically through strength training and hormone therapy, the latter more often recommended for women than men. Rarely are people in their 40s getting these messages.
Scientists agree as we age, our cells, tissues and systems deteriorate. In its most severe form, that deterioration can lead to age-related diseases such as cancer, arthritis and Alzheimer’s. Because the risk of developing these diseases rises after the age of 65 – and because people over 65 make up an increasingly bigger proportion of America’s population – those groups typically come to mind when we think about ageing.
But in our 40s we will inevitably confront the cold, hard reality of biology, too: our bodies won’t stay as strong, or repair or metabolise like they used to. This is despite the fact we’ve been told 40 is the new 30.
Dr Vonda Wright, a 57-year-old orthopaedic surgeon in Florida, is one of a growing number of doctor-influencers on Instagram and other platforms trying to educate people in midlife about optimising health and athletic performance.
She says the 12 so-called hallmarks of ageing – the ways cells, tissues and systems degrade as we age – start appearing in our 30s and speed up when we reach our 40s. “Why suddenly are people in their mid-40s who have always felt like themselves finding they can’t squeeze out the performance anymore?” Wright told me. “It’s because, number one, the hallmarks of ageing are catching up to us, and number two, in the case of women, we’re rapidly losing estrogen.” (Men also lose testosterone over time, but typically at a slower rate than women lose estrogen.)
While we tend to think of estrogen and testosterone as fuelling reproduction, they also send signals to muscle cells to replicate and grow. When levels run low, it can be harder for those cells to turn over and develop, leading to weaker muscles.
Women typically lose estrogen faster than men lose testosterone, impacting muscle strength. Photo / 123RF
More doctors like Wright are now talking to many of their patients in midlife about menopausal hormone therapy, in part because for some women, it may be more beneficial than they realise. They’re also encouraging them to build strength and power to avoid devastating injuries such as fractures that can land people in the operating room.
It wasn’t that long ago that cardiovascular exercise was the default activity recommended for health. But the evidence now shows incorporating strength training as you age not only counters weakening muscles and prevents injuries but also is good for metabolism, the heart and the brain. Late last year, the American Heart Association updated its guidelines to recommend this kind of training for cardiovascular health.
Yet only 28% of adults in the United States get the recommended amount of exercise, which includes lifting weights at least twice a week. Though I’d dabbled in strength training, it was only when I started paying attention to experts on ageing that I realised this was probably the most important part of my exercise routine. I also discovered I had to lift heavier, meaning 10-pound dumbbells and up, to stress my body enough to get all the possible benefits.
So, yes, science suggests our 40s are a pivotal time when our bodies begin to assert their limits. For those of us who have always been active, the goal of exercise may have to evolve. For me, I’m now thinking less about chasing peak performance and more about challenging my weakening muscles and avoiding injuries.
To focus on strength training in our 40s is to acknowledge this change and also realise we can fortify our bodies with new capabilities. For people who don’t regularly exercise, that could mean building a body that’s stronger and fitter than it ever has been. Certainly, the strength training advocates I’ve encountered embody something that, to me, feels powerful and new: incredibly fit middle-aged people training for health, performance and longevity.
These days, whether I am doing a leg lift to heal my hamstring or a deadlift to coax my muscles out of frailty, I find a deep pleasure in the burn. And I’m far less intimidated by the notion of turning 50 – it’s just another decade to get ripped.
