Menopause, Andropause and now “Somatopause”?

bodybuilder poseWell it’s no secret what menopause is.  Luckily there’s an increasing body of information widely available out about it these days.  Among other hormonal shifts, the primary change in menopause and peri-menopause occurs with estrogen levels.  Estrogen production decreases as women age, and move away from the reproductive stage of life.

Men have an equivalent transition as their androgens shift and the production of testosterone wanes.

Somatopause is not as commonly discussed and the term might be unfamiliar, but depending on your age you might not be surprised to hear what it is.  This is a change that happens for both men and women as we approach later life.  The prefix soma comes from the Greek meaning “body”.  In medicine the term somatic refers to the physical body – the machine: muscles and bones.

If you’re someone who’s nearing mid life or just past it, then you may already have noticed that your body is definitely changing – possibly even before you notice changes in estrogen or testosterone.  In addition to finding hairs where there didn’t used to be any or skin tags in inconvenient places, skin may not be as firm or as thick, but above all, our muscle mass is suddenly not what it used to be.  Many middle aged people will notice that seeing and feeling the results of exercise becomes harder and harder.  It becomes really easy to lose the effects of exercise.  The decrease in muscle mass and the decreased ability to build muscle is what the term “somatopause” refers to.

Somatopause, or this decrease in muscle mass, just like the other two ” -pauses”, is also because of a decreasing hormone.  In this case it’s the human growth hormone (HGH).  The human muscle cell (sarcomere) needs HGH in order to grow.   Our body stops naturally making as much growth hormone as we do when we’re younger.

Does this mean we should all just roll over and become flabby and weak?  We certainly can but it’s not a fate we have to accept silently. At the very least this information should make us want to work a little harder at staying with an exercise regimen.  The “Move it or Lose it” adage definitely becomes louder and clearer the older we get.

Incidentally, there’s some really interesting evidence just coming to light recently that seems responsible for feeding yet another trendy exercise fad.  In recent months you may have heard more and more about high intensity interval training.  The allure of this kind of workout is that it touts much less of a time commitment in the gym (for the busy professionals) but promising to deliver the same or better outcomes fitness-wise.

Well, I’m the first to dig my heels in when I notice the frenzy for a fad taking hold and I always advise caution to all patients considering trying this particular one – no matter what age.  The potential for injury is high when we combine speed or time stress with intensity since neither leave much room for focusing on safe form unless closely supervised.  So, I generally don’t advise anyone to do this kind of training, but I am changing my tune a little bit and here’s why:

Studies have shown this kind of training appreciably stimulates an increase in growth hormone production. So, if  it’s done safely, the high intensity, short spurts of exercise can be particularly useful to those of us approaching somatopause.  The added stints of growth hormone production will aid in the building of muscle mass even in someone who has entered this stage of life where the natural decline of HGH has begun!

If you’re struggling to put on muscle mass don’t forget to think about your nutrient intake but you might as well also consider  kicking it up a notch once or twice a week for the sake of these muscle building benefits.  But don’t leave behind the traditional workouts that you enjoy.  It’s far too important to our brain chemistry to leave those behind.  Workouts of a minimum of 30 min. and longer, will be what give you a good dose of “happy chemicals”.  These will become more important as you add the naturally more stress hormone inducing high intensity workouts, simply for balance. (Take a moment to read this post to learn why it’s important for some people to be especially careful with stress inducing activities – you might be adding fuel to the fire despite your best intentions)

I hope you’ll consider the fact that maintaining and gaining muscle mass at all ages is not just about looks. You will look great and feel much better about your looks but more importantly, it’s very much about life sustaining function that will make all aspects of daily living easier, safer and seamless.  It’s a biological fact that movement is ultimately what sustains life and you can’t move if you don’t have muscle!

 

References:

http://fitness.mercola.com/sites/fitness/archive/2013/06/21/interval-training.aspx

http://www.ncbi.nlm.nih.gov/pubmed/10442584

Do You Think Your Weight is Causing Your Back Pain? Not So Fast.

Big_Fat_Red_Cat

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If you are carrying a little more weight than you would like or than is considered technically ideal for your frame, then you probably already have enough guilt and shame around this.  If you’re overweight and you have back pain the last thing you want to hear and yet the first thing you’re ready to assume is that your back pain is because of your weight.

This assumption is a very common one because according to popular media, obesity is the reason for all of our problems.  I don’t deny that morbid obesity is called “morbid” for a reason.  It will tend to shorten your life according to the science.  But when it comes to back pain the connection isn’t as clear as you think if you’re just moderately overweight – and I use the term “overweight” loosely because standardized charts that tell us who is and isn’t “too heavy” do not take into account body density, composition and activity level.

Focusing on and stressing about your weight is a sure fire way to put on more pounds and it won’t do a darn thing for your pain.

I’ve been seeing and treating back pain of all shapes and sizes for over twenty years and the only common thread is inflammation – not size, not shape, not weight.  Inflammation can reach critical mass anywhere in any body and when it does, our structurally and chemically vulnerable areas will be where we experience the discomfort of that inflammation…and sometimes that comes in the form of back pain.  The story of inflammation is extremely complex and deserves more than a blog post to do it justice, but the bottom line is that inflammation is triggered by three main things:

  1. mechanical stress or imbalance
  2. chemical stress or imbalance
  3. emotional stress or imbalance

These imbalances have to reach a critical mass before they cause any pain at all, so they often go on for years undetected and then when there finally is pain, we are reluctant to acknowledge these real causes and instead turn our attention to the easy target like body weight.  Each of these three things when out of balance, can be caused by excess body weight but are also caused by a multitude of other things that aren’t necessarily related to being overweight.  Plenty of skinny people have back pain.

Heavy and thin people alike put their spines under mechanical strain by sitting too much and developing poor body movement mechanics throughout life.  None of us will know it until we are in pain.  Then we can’t help but notice all the things we thought were okay to do suddenly hurt like crazy.

Heavy and thin people alike put their body under chemical stress by the foods they choose to eat or the toxins and allergens they are inadvertently exposed to.  Some have genetic predispositions to experience chemical stress more easily than others.

Heavy and thin people alike experience emotional stress with varying sensitivities and thresholds; all of which can add to the expression of inflammation.

It’s not your weight, but it might be your fat to muscle ratio…

…and this is something that the lean crowd should be sure not to overlook, because it’s easy to buy into the pervasive notion that someone is healthy just because they’re thin but no one is exempt from having a high fat to muscle ratio.

Fatty tissue is also called adipose.  Adipose produces a type of cell called an adipokine.  Adipokines are cell signaling proteins that help fatty cells communicate with the rest of the body.  Unfortunately these adipokines are pro-inflammatory and the more adipose you have the more inflammation your own body will produce.

On the up side, muscle cells – when active – secrete something called a myokine and for a reason that still eludes researchers, even though this myokine is in the same family as adipokines, it exerts an anti-inflammatory effect on the body!  What better motivation could there possibly be for getting your body moving?!  This is such a no-brainer.  Keep your muscle to fat ratio high and you’re much less likely to have back pain associated with chemically inflammatory adipose.

It’s not your weight alone, but it might be if it was a sudden gain…

What I’ve observed is that when there’s a sudden weight gain, like with pregnancy for example, there is a much greater probability that back pain is related to that weight gain because it’s a sudden change that the structures of the spine haven’t had time to adapt to.  When someone has had the same proportion of “extra” weight without much fluctuation throughout most of their life, then the back pain is less likely related to weight.

It’s not your weight, it’s the fact that you think  it’s your weight.

Now that you know it’s not necessarily your weight that is causing your pain, you can stop stressing about it. Just this simple decrease in stress is going to lower the inflammation in your body…and possibly make it easier for you to shake the pain.

The other problem with people who are stressed about their full figures, is that they will adopt the particularly stressful body habits of trying to suck in the gut and tucking the butt.  You can read more about why these are so bad for your back here, but for now do your best to eliminate that mechanically inflammatory habit!

For most moderately overweight bodies losing weight is not the answer to back pain.  Gaining strength and muscular balance is  the answer for all body types when dealing with back pain.  This is not to say that taking a few pounds off would not ease the load on any skeleton in pain but to focus on weight loss will backfire eventually and is not a good use of your energy.  To focus on strength building will cause an incidental weight loss that is much more sustainable and far reaching.

Even if you’re not in pain, please stop fixating solely on what and how much goes in your mouth, and start focusing on moving your body to make it stronger.

To read more about what is really behind your back pain go to Stop Everyday Pain.

 

References:

Advances in Medical Sciences 2009, 54(2): 150-157 Role of adipokines in complications related to obesity. A review. Gnacinska M et al.

Journal of Experimental Biology 2011; 214(337-346) Muscles and their myokines. Pedersen BK.

Science 1991 Oct 18;254(5030):421-3.Autocrine or paracrine inflammatory actions of corticotropin-releasing hormone in vivo. Karalis K, Sano H, Redwine J, Listwak S, Wilder RL, Chrousos GP.

“It’s Probably Just Muscle Pain, Right?”

body art

image credit: wikimedia.org

This is something I hear patients say all the time when they come to see me.  Almost as if to apologize for not having something more dramatic to show for their pain or look for reassurance that it’s nothing too serious.

Guess what? It probably is “just” a muscle and that’s a perfectly adequate reason for your pain.  It may not seem serious if it’s “just” a muscle but it’s not a free pass for you to shrug it off just because it’s not life threatening.  Most of the pain that we experience when we’re talking about the everyday variety of pain is soft tissue based.  This means it’s not commonly coming from your bones or discs unless you’ve had a very distinct physical trauma recently or are in an advanced state of chronic dysfunction which you would already know about from a looong history of pain.  Of course it’s up to the professional you choose to see to find out whether or not there is a more serious underlying cause for your pain.  I can only speak of generalities based on the vast majority of pain that I treat conservatively in my chiropractic practice.

A lot of the pain I see and treat is something that sneaks up on people, for example: the pain that you wake up with after going to bed feeling fine or the pain you discover when you try to stand up from your desk or the couch.  These kinds of everyday pains  are generally being generated by the strain and damage to muscles, tendons, ligaments and joint capsules.  The reason  these structures are stressed and signaling pain is what I’m  always interested in.  The relationship between bones and joints, either during movement or at rest or during transitions from inactivity to activity, are the reasons that the soft tissues of the body start to complain with pain.  Because it’s up to the soft tissues to hold everything together they are the ones that will be the first to notice if un safe movement or positioning is happening.

Sometimes figuring out which combination of movements, habits or positions led to the irritation of these pain generating structures is the complicated part.  Determining these things is usually key to lasting relief.

What I do with chiropractic is restore normal functioning to the joints of the body that have stopped pulling their full weight.  Sometimes the joints stop working optimally because of pain in the soft tissues and sometimes other reasons cause the joints to stop working fully first and then the resulting uneven work load is the reason for the soft tissue pain.  Restoring motion is the first step.  That usually brings a lot of relief from the pain. Then comes the hard work of maintaining that healthy movement on a daily basis in order to keep those muscles from hurting.  Sometimes this requires a complete re-assessment of how to go about the daily tasks that we come to take for granted like brushing our teeth or washing the dishes or even what we think is restorative unwinding on the couch.

Read more about how to stop everyday pain here.