Last year I had to give up running. As my sports medicine doctor advised, it was “time.”
It has been my main form of exercise and stress relief since I was a teenager. But for months I ignored the small signs of encroaching frailty: the crunching and grinding sounds in my right knee and hip whenever I stood, bent over, or climbed stairs. The medical term for this is crepitus, but I continued to stubbornly convince myself that I was still a “young” fifty-year-old man.
I have internalized the common positive message of aging: “50 is the new 30.” However, as far as the cells that make up my knee and hip tendons and cartilage are concerned, 50 is still a lot of 50. So much for the popular idea that our common “…biological agemay be much younger than our chronological age.
For decades, I did everything the experts recommended—eat well, sleep well, exercise—and yet my doctor still told me it was time to adapt to my changing body.
My physical therapist told me that many of his Gen X patients, who are now in their 40s and 50s, have bought into the idea that age shouldn't be a factor when it comes to what exercises they do or how they do them. Every trendy sport or exercise sends a new wave of us to his office, and others love it. For example, 2020 study found that nearly 91% of people admitted to the emergency department with pickleball-related injuries were over 50 years of age.
Many people approach their fitness as if they were ten or two years younger. My doctor told me that patients over 50 are often upset by any suggestion that their daily routine will have to change. I began to see this denial of physical reality everywhere. One of my colleagues injured her shoulder doing CrossFit and then re-injured herself months later doing the same exercise. A friend who had been doing yoga for decades broke her chin falling from crow pose. When I suggested she change her daily routine, she chuckled.
As a medical anthropologist, I wondered whether anti-aging messages had inadvertently created a new problem. Was our generation endangered not by lack of physical activity, like the Boomers and Silent Generations before us, but by over-exercising?
How our body changes as we age
Dr. Emily Finkelstein, a geriatrician at Weill Cornell Medicine, likes that people in their 40s, 50s and 60s have learned that exercise is important for healthy aging and longevity. There are some practical considerations, though.
“Our muscle mass and our performance peak around age 30,” Finkelstein said, “and begin to decline naturally after that. We really need to be flexible in terms of what we do and what we expect of ourselves.”
As we approach age 45, we begin to lose critical muscle mass, which can reduce our strength and balance. Decreased bone density can make us more vulnerable to stress fractures due to repetitive motion and stress. The cartilage in our joints becomes thinner and the tendons and ligaments become stiff. All this means is that we are more prone to injury during physical activity. Recovery also takes longer.
“What people don’t know or learn,” said Dr. Rosanne Leipzig, “is that aging starts at birth and your abilities will definitely change.” Leipzig knows quite a bit about this process, both as a professor of geriatrics and palliative medicine at the Icahn School of Medicine at Mount Sinai and as a man in his 70s.
“You peak in muscle mass, bone strength, ability to remember lists of words, all by age 30. And after that, it all starts to decline,” she said. “Getting older doesn't mean you can't do the things you used to do, but you probably can't do as much in the same period of time.”
Most experts agreed that messages like “50 is the new 30” can be helpful if they persuade people not to write themselves off as they age. It's okay to push yourself a little physically. But the downside is the assumption that a 50-year-old's body is no different from a 30-year-old's. This.
“One of the best things we can do for our own healthy aging is to be flexible and adaptable,” Finkelstein said. “We need to change our expectations and change the way we train as we get older.”
How to adapt to hypertensionebody and avoid injury
In middle age, we should all learn to be in harmony with our bodies. This may mean taking more time to recover between intense workouts, stretching more, and incorporating more weights into our fitness routines.
A healthy, adaptive approach to exercising as we age may include regular self-monitoring and evaluation of how our bodies are feeling during and after exercise, and contacting a qualified healthcare professional when we begin to notice any signs or symptoms of an increasing problem, such as pain or discomfort.
Leipzig suggests that doctors begin conversations about change by asking patients what they like about the activity they are doing. A tennis player may really enjoy the social aspect. In this case, they could switch to pickleball—which is less strenuous but similar—with an additional regimen of strength training and stretching to prevent injury.
But since the risk of injury naturally increases with age, it's also important to have a backup plan in case we overdo it. When I spoke with Dr. Melissa Leber, assistant professor of orthopedics and emergency medicine at the Icahn School of Medicine, she had just finished working at the U.S. Open. Leber has extensive experience working with athletes—both professional and amateur—who have overextended themselves.
“Some people are really adaptable and comfortable with changing their body,” Leber said. “Others make concessions. I've seen patients who don't even need a day off.”
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Leber advises patients to change things up by allowing their body to heal. So, if you're a runner and injured, try a modified strength training program and a lower-impact activity like swimming. Then, when you start running again, run fewer times per week or for shorter distances. To avoid injury or fatigue, experts recommend at least one or two days of rest per week.
Strength training is also very important. “The stronger you are,” Leber said, “the more you will avoid injury and fall. And when you do fall, you will fall differently. Your balance will be better and you will recover from injury faster.”
As a general rule, Leber advises people over 50 to spend 50% of their total workout time on strength training and 50% on cardio. By age 60, this figure should be 60% strength training and 40% cardio training. By age 70, cardio should only make up 30% of your workout.
All the experts I spoke with agree that pain should never be ignored—and pain should never be pushed through without seeing a doctor. However, Finkelstein noted that most general practitioners are not that well trained in exercise physiology. It is best to consult a physical therapist, exercise medicine and rehabilitation specialist, or certified exercise coach for specific recommendations regarding your exercise routine.
“I wish we were all better trained on this,” Finkelstein said, “because it’s so important.”
On top of this, conversations about how to maintain muscle mass, bone health, aerobic capacity and cardiovascular health take up more time than the average physician can spend with their patients. Many people fill this gap with advice from online fitness influencers.
Setting realistic expectations for agricultureeing
Finkelstein worries about the influence of the media—especially social media, with its legions of health and anti-aging influencers. “Take these supplements, do this exercise program, join this fitness program: you name it, people serve it up,” she said. “I'm very concerned about this in terms of the reliability of these people and the science behind what they're proposing, as well as people's vulnerability to it, because you want to do everything you can to stay healthy and young.”
Popular media also likes to portray “superagers”—people whose mental and/or physical abilities are comparable to those 20 to 30 years younger. And while it's nice to see, say, an 87-year-old running a marathon, it can lead to false expectations about normal aging. Superagers are rare; only about 10% of the general population meets all criteria for inclusion in this category.
In other words, for those of us in middle age or older, it's not very realistic to think that we'll be setting these personal bests forever. As experts constantly emphasize, the best approach to training as you age is realistic and adaptive. A runner who adapts to the changes in his aging body and trains effectively may still be able to run the Boston Marathon, but the time it takes him to cross the finish line is sure to increase.
Part of the problem may be an optimism bias. Although we may logically understand that bodies change, we don't think that we actually change. Perhaps this is because we live in a culture that is obsessed not only with longevity, but also with the desire to look younger. The number of cosmetic procedures has increased. increased by 42.5% in the world over the past four years, and Americans have spent approximately $20 billion for cosmetic surgery in 2024.
“We have a huge problem in our society with accepting that things are going to change,” Leipzig said. “People in general are in better shape than ever if they are privileged enough to be able to take care of their needs, but this makes them think they will never die. This leads to ageism.”
And here's the rub: Being overly concerned about how “young” you are for your age is just another form of bias you may hold against your future self. “Fifty is the new 30” simply highlights our misconception that being healthy means not aging at all. It would be more helpful if we reminded ourselves from time to time that aging is a privilege; that “50 is 50” and “80 is 80” – and there is absolutely nothing wrong with that.
