This post is packed full of information about how to keep fit and healthy now and into the future. With the NHS in crisis it’s never been more important for us to do all we can to look after ourselves both to hopefully avoid needing to use the NHS and also to prepare ourselves for a healthier older age. We all know about 5 servings of fruit/veg a day and the importance of exercise and now the government have put together some really helpful guidance regarding exercise levels for different ages and abilities as well as some other healthy options that we can take. I found this paper really interesting and thought I’d share it. For the full paper please see the link at the bottom of this.
As a physio I see people day to day who are in pain. As part of my treatments I’m always looking at why problems occur to help work out how they can be prevented in the future. There are many things that we can do to help prevent musculoskeletal pain such as maintaing a healthy weight and avoiding long hours of sitting or highly repetitive activities without taking a break. For more information please read on.
The content of this post is based on and taken from the Government Guidance March 2022 – Applying All Out Health.
‘Why is good musculoskeletal health important?
Good musculoskeletal health (MSK) is an important component of maintaining a person’s functional abilities throughout the life course. It is also fundamental to healthy ageing, which the World Health Organization (WHO) has characterised as ‘the process of developing and maintaining the functional ability that enables wellbeing in older age’.
Social perceptions of ageing are gradually changing. People increasingly expect to lead independent, active and pain-free lives in their older years. For many people this includes remaining part of the workforce. For most this includes an active retirement, without the fear of pain and falls.
MSK conditions can affect people across the life course. Prevention, early detection and treatment can enable people to live in good health, remain independent and connected to one’s community. There are also economic advantages for society, such as reducing the pressure on health and social care services and reducing costs as a result of people being unable to work.
MSK conditions are a group of conditions that affect the bones, joints, muscles and spine, and are a common cause of severe long term pain and physical disability. There are 3 groups of MSK conditions:
- inflammatory conditions, for example, rheumatoid arthritis
- conditions of MSK pain, for example, osteoarthritis and back pain
- osteoporosis and fragility fractures, for example, a fracture after a fall from standing height
While life expectancy has risen, many people are living longer in poorer health. The older a person is, the more likely they are to experience chronic diseases and disabilities such as poor musculoskeletal health.
Each year, 20% of people in the UK see a doctor about a MSK problem. There are multiple risk factors that can heighten people’s susceptibility to MSK problems – these include physical inactivity, being overweight or obese, diets deficient in vitamin D or calcium, smoking, older age and genetic predisposition to some MSK conditions.
Seven in 10 people who report living with a long-term MSK condition are overweight or obese.
Fractures, which are often a consequence of a fall, are one of the most serious MSK problems seen in the older population. An audit by the Royal College of Physicians found that fractures and falls in people aged 65 and over account for over 4 million hospital bed days each year in England. MSK conditions account for the third-largest area of NHS spend, about £5 billion each year.
The pain and disability of poor MSK health limits independence and the ability to participate in family, social and working life. According to Versus Arthritis, only 59.4% of people of working age with a MSK condition are in work, and around 1 in 5 people with arthritis has depression.
In 2020, MSK problems were the second most common cause of sickness absence, which accounted for 20.8 million days lost in work (17.5% of total sickness absence), surpassed only by absence due to minor illness such as cough and colds.’
As you can see from these stats, there’s a strong chance that many of us will get MSK problems that come with older age, if not early through other things. So you can see it’s vital that we take steps as individuals, locally and nationally to make the keep the future looking bright
‘Interventions to prevent the onset of MSK
There are steps that we can take throughout our lives to maintain healthy productive lives, reduce the risk of developing MSK conditions and better manage our health.
* Physical activity
Adults should aim to do activities to develop or maintain muscle strengthening on 2 days per week, engage in at least 150 minutes of moderate intensity physical activity each week, according to physical activity guidelines for adults from the UK Chief Medical Officers (CMOs). Adults should also minimise time spent being sedentary and when possible, break up periods of inactivity with activity.
All adults should aim to be active daily. Strengthening activities should be in major muscle groups, such as resistance exercises, yoga or carrying heavy shopping.
Moderate intensity physical activities, such as brisk walking or cycling, cause adults to get warmer and breathe harder and their hearts to beat faster, but they can still carry on a conversation.
In older adults, poor muscle strength increases the risk of a fall by 76% and those who have already had a fall are three times more likely to fall again. Activities to improve or maintain muscle strength, balance and flexibility on at least 2 days a week, are therefore important for older adults.
An evidence review commissioned by the Centre for Ageing Better has found that muscle and bone strengthening and balance activities continue to have great health benefits for all adults, including older adults aged 65 years and over.
Activities found to have the most benefit for muscle and bone strengthening include:
- ball games
- racket sports
- Nordic walking
- resistance training (usually training with weights, but including body weight exercises which can be performed anywhere)
More than 4 in 10 people who report living with a long-term MSK condition are inactive:
Many people with MSK conditions often mistakenly believe that physical activity will make their condition worse when it can actually benefit them. Versus Arthritis has produced the Musculoskeletal Physical Activity Commissioning Pyramid which sets out the 4 tiers of provision that could be provided to maximise people’s opportunities for physical activity. The goal is to reduce symptoms, increase self-efficacy and restore confidence to be more independently physically active.’
See the links below for information regarding exercise levels for different ages all provided through the government guidance:
Physically disabled and disabled young people
Pregnancy and after child birth
* Maintain a healthy weight and balanced diet
Supporting people to maintain a healthy weight – along with advocating the recommendations from the Chief Medical Officers (CMOs) for physical activity across the life course – can reduce the risks of developing MSK conditions such as back and neck pain and osteoarthritis of the knee and hip.
People with a healthy weight are less likely to develop osteoarthritis of the knee than those who are obese.
A healthy balanced diet (PDF, 10.3MB) is also important for good bone health to prevent osteoporosis in later life. The Scientific Advisory Committee on Nutrition (SACN) identifies vitamin D and calcium as important dietary components for MSK health through maintaining healthy bones, teeth and muscles.
OHID advises that in spring and summer, the majority of the population get enough vitamin D through sunlight on the skin and a healthy, balanced diet. During autumn and winter, everyone will need to rely on dietary sources of vitamin D. Since it is difficult for people to meet the 10 microgram recommendation from consuming foods naturally containing or fortified with vitamin D, people are advised to consider taking a daily supplement containing 10 micrograms of vitamin D in autumn and winter.
People whose skin has little or no exposure to the sun, like those in institutions such as care homes, or who always cover their skin when outside, risk vitamin D deficiency and need to take a supplement throughout the year. Ethnic minority groups with dark skin, from African, Afro-Caribbean and South Asian backgrounds, may not get enough vitamin D from sunlight in the summer and therefore should consider taking a supplement all year round.
Calcium is needed for good bone health. Eating a diet consistent with the Eatwell Guide will provide all the calcium your body needs.
Smokers and ex-smokers experience 60% more pain in the back, neck and legs and a 114% increase in disabling lower back pain.
A review showed that smoking plays a role in the progressive decline of the body’s major systems, including MSK.
- is associated with poorer development of the hip, spine and neck, and lower bone mineral density among men as young as 18 to 20
- has a particularly greater impact on reduced bone mineral density among postmenopausal women
- is associated with more bone fractures and slower healing and is associated with up to a 40% increase in the risk of hip fractures among men
- is a significant cause of rheumatoid arthritis, especially among men, and can also reduce the impact of treatment
* Mental wellbeing
Mental health conditions can increase the likelihood of developing some MSK disorders. For example, people with depression are at greater risk of developing back pain. MSK conditions can also have a significant impact on mental health as living with a painful condition can lead to anxiety and depression, and depression is 4 times more common among people in persistent pain compared with those without pain.
A recent study found that 33.9% of older adults (over 50) with MSK pain also have persistent anxiety issues and 22% have a persistent depression problem. Mental health also has an impact on a person’s ability to deal with an MSK problem.
I hope you’ve found this helpful and if you have any questions regarding any aches and pains and how you might be able to get rid of them please do let me know.