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

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 lead 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!

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.


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