Sports Medicine

, Volume 20, Issue 1, pp 41–52 | Cite as

Aging, Physical Activity and Sports Injuries

An Overview of Common Sports Injuries in the Elderly
  • Mauri Kallinen
  • Alen Markku
Injury Clinic


Illness and aging both cause many structural and functional alterations in the human body, rendering elderly people liable to overloading of the musculoskeletal and cardiovascular systems. It should, however, be kept in mind that immobilisation and inactivity have even more deleterious effects on structures and functions in the elderly than in younger adults. Most physically active elderly people are selected individuals with respect to their superior health and physical capacity compared with inactive persons of the same age, thus making it possible to further improve their physical capacity. They will, however, be affected by some of the drawbacks of physical overloading, mostly due to the diminished ability of aging body systems to adapt to high levels of loading. The safety margin of an exercise dose tends to decline with aging. Exertional injuries are common among the elderly, and are connected mostly with degenerative aging processes.

Acute injuries are common in those elderly people participating in sport activities which demand high coordination, reaction time, and balance capabilities, such as ball games, down-hill skiing, and gymnastics. Muscle has been reported to be the most commonly acutely injured tissue among active elderly athletes. The lower extremities are the most susceptible to injury. A large proportion of injuries (acute and exertional) are mild and can be treated by brief cessation of training and competition activities. Some of the injuries are, however, long term and cause disability not only during training and competition, but also in the normal activities of daily living.

It is important that these injuries are treated as soon as possible and in the most effective way, similarly to injuries suffered by younger people. In treating elderly people, it is most important to avoid the detrimental effects of immobilisation; this requires active treatment and rehabilitation with compensatory exercise therapy. The best ‘treatment’ for sports-related injuries is prevention. Good agility, technical skills, and cardiovascular and musculoskeletal fitness are important in injury prevention among the elderly. Appropriate training programmes, the use of safe and familiar equipment, careful warming up and cooling down, multiphasic training [including the training of neurophysiological functions (balance, coordination and reaction time)] and muscle strength are essential aspects of injury prevention.


Injury Prevention Acute Injury Sport Injury Overuse Injury Plantar Fasciitis 
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  1. 1.
    Kirkwood TBL. Biological origins of ageing. In: Evans JG, Williams FT, editors. Oxford Textbook of Geriatric Medicine. Oxford: Oxford University Press, 1992: 35–40Google Scholar
  2. 2.
    Olshansky JS, Carnes BA, Cassel C. In search of Methuselah: estimating the upper limits to human longevity. Science 1990; 250: 634–40PubMedCrossRefGoogle Scholar
  3. 3.
    Oja P, Miilunpalo S, Vuori I, et al. Trends of health-related physical activity in Finland: 10-year follow-up of an adult cohort in eastern Finland. Scand J Med Sci Sports Exerc 1994; 4:75–81CrossRefGoogle Scholar
  4. 4.
    Curtis JE, White PG. Age and sport participation: decline in participation or increased specialization with age? In: Theberge N, Donnelly P, editors. Sport and the sociological imagination. Fort Worth: Texas Christian University, 1984: 279–93Google Scholar
  5. 5.
    Harada M. Early and later life sport participation patterns among the active elderly in Japan. J Aging Phys Activity 1994; 2: 105–14Google Scholar
  6. 6.
    Menard D, Stanish WD. The aging athlete. Am J Sports Med 1989; 17: 187–96PubMedCrossRefGoogle Scholar
  7. 7.
    Sarna S. Increased life expectancy of former Finnish world class athletes. Med Sci Sports Exerc 1993; 25: 237–44PubMedGoogle Scholar
  8. 8.
    Fogelholm M, Kaprio J, Sarna S. Healthy life-styles of former Finnish world class athletes. Med Sci Sports Exerc 1994; 26: 224–9PubMedCrossRefGoogle Scholar
  9. 9.
    Pescatello LS, DiPietro L. Physical activity in older adults: an overview of health benefits. Sports Med 1993; 15: 353–64PubMedCrossRefGoogle Scholar
  10. 10.
    Pollock ML, Dawson GA, Miller Jr HS, et al. Physiologic responses of men 49 to 65 years of age to endurance training. J Am Geriatr Soc 1976; 24: 97–104PubMedGoogle Scholar
  11. 11.
    Pollock ML, Foster C, Knapp D. Effect of age and training on aerobic-capacity and body composition of master athletes. J Appl Physiol 1987; 62: 625–31Google Scholar
  12. 12.
    Kasch FW, Boyer JL, Van Camp SP, et al. Effect of exercise on cardiovascular aging. Age Ageing 1993; 22: 5–10PubMedCrossRefGoogle Scholar
  13. 13.
    Grimby, G, Saltin, B. The aging muscle. Clin Physiol 1983; 3: 209–18PubMedCrossRefGoogle Scholar
  14. 14.
    Fiatarone MA, O’Neill EF, Ryan ND, et al. Exercise training and nutritional supplementation for physical frailty in very elderly people. New Engl J Med 1994; 330: 1769–75PubMedCrossRefGoogle Scholar
  15. 15.
    Era P, Pärssinen O, Suominen H. Neurophysiological aspects of exercise among the elderly. In: Oja P, Telama R, editors. Sport for all. Proceedings of the World Congress on Sport for All; 1990 Jun 3–7: Tampere, Finland. Amsterdam: Elsevier Science Publishers, 1991: 343–51Google Scholar
  16. 16.
    Panton LB, Graves JE, Pollock ML, et al. Effect of aerobic and resistance training on fractionated reaction time and speed of movement. J Gerontol 1990; 45: M26–M31PubMedGoogle Scholar
  17. 17.
    Gutin B, Kasper MJ. Can vigorous exercise play a role in osteoporosis prevention? A review. Osteopor Int 1992; 2: 55–69CrossRefGoogle Scholar
  18. 18.
    Suominen H, Rahkila P. Bone mineral density of the calcaneus in 70- to 81-yr-old male athletes and a population sample. Med Sci Sports Exerc 1991; 23: 1227–33PubMedGoogle Scholar
  19. 19.
    Kujala UM, Alen MA, Huhtaniemi IT. Gonadotrophin-releasing hormone and human chorionic gonadotrophin tests reveal that both hypothalamic and testicular endocrine functions are suppressed during acute prolonged physical exercise. Clin Endocrinol 1990; 33: 219–25CrossRefGoogle Scholar
  20. 20.
    Heuser IJE, Wark H-J, Keul J, et al. Hypothalamic-pituitaryadrenal axis function in elderly endurance athletes. J Clin Endocrinol Metab 1991; 73: 485–8PubMedCrossRefGoogle Scholar
  21. 21.
    Haskell WL. Health consequences of physical activity: understanding and challenges regarding dose-response. Med Sci Sports Exerc 1994; 26: 649–60PubMedCrossRefGoogle Scholar
  22. 22.
    American College of Sports Medicine. Guidelines for exercise testing and prescription, 4th ed. Philadelphia: Lea & Febiger, 1991Google Scholar
  23. 23.
    Pollock ML, Graves JE, Swart DL, et al. Exercise training and prescription for the elderly. South Med J 1994; 87: S88–S95PubMedGoogle Scholar
  24. 24.
    Martin GM. Biological mechanisms of ageing. In: Evans JG, Williams FT, editors. Oxford Textbook of Geriatric Medicine. Oxford University Press, 1992: 41-8Google Scholar
  25. 25.
    Barja G, Cadenas S, Rojas C, et al. A decrease of free radical production near critical targets as a cause of maximum longevity in animals. Compr Biochem Molec Biol 1994; 108: 501–12Google Scholar
  26. 26.
    Cerami A, Vlassara H, Brownlee M. Glucose and aging. Sci Am 1987; 256: 82–9CrossRefGoogle Scholar
  27. 27.
    Smith EL, Gilligan C. Exercise, sport, and physical activity for the elderly: principles and problems of programming. In: McPherson BD, editor. The 1984 Olympic Scientific Congress Proceedings, Champaign, Ill. Human Kinetics Publishers 1986: 91-105Google Scholar
  28. 28.
    Kauppila LI, Tallroth K. Postmortem angiographie findings for arteries supplying the lumbar spine: their relationship to lowback symptoms. J Spinal Dis 1993; 6: 124–9CrossRefGoogle Scholar
  29. 29.
    Penttinen J. Back pain and risk of fatal ischaemic heart disease: 13 year follow up of Finnish farmers. BMJ 1994; 309: 1267–8PubMedCrossRefGoogle Scholar
  30. 30.
    Zerba E, Komorowski TE, Faulkner JA. The role of free radicals in skeletal muscle injury in young, adult, and old mice. Am J Physiol 1990; 258: C429–C435PubMedGoogle Scholar
  31. 31.
    Brooks SV, Faulkner JA. Skeletal muscle weakness in old age: underlying mechanisms. Med Sci Sports Exerc 1994; 26: 432–9PubMedGoogle Scholar
  32. 32.
    Shephard RJ. Physical activity and aging. 2nd ed. London: Croom Helm Publishing, 1987Google Scholar
  33. 33.
    Booth FW, Weeden SH, Tseng BS. Effect of aging on human skeletal muscle and motor function. Med Sci Sports Exerc 1993; 26: 556–60Google Scholar
  34. 34.
    Anderson RA, Bancroft J, Wu FWC. The effects of exogenous testosterone on sexuality and mood of normal men. J Clin Endocrinol Metab 1992; 75: 1503–7PubMedCrossRefGoogle Scholar
  35. 35.
    Tenover JS. Effects of testosterone supplementation in the aging male. J Clin Endocrinol Metab 1992; 75: 1092–8PubMedCrossRefGoogle Scholar
  36. 36.
    Young NR, Baker HWG, Liu G, et al. Body composition and muscle strength in healthy men receiving testosterone enanthate for contraception. J Clin Endocrinol Metab 1993; 77: 1028–32PubMedCrossRefGoogle Scholar
  37. 37.
    Leblanc A, Gogia P, Schneider V, et al. Calf muscle area and strength changes after five weeks of horizontal bed rest. Am J Sports Med 1988; 16:624–9PubMedCrossRefGoogle Scholar
  38. 38.
    Baker SP, Harvey AH. Fall injuries in the elderly. Clin Geriatr Med 1985; 1:501–12PubMedGoogle Scholar
  39. 39.
    Tinetti ME, Speechley M. Prevention of falls among the elderly. New Engl J Med 1989; 320: 1055–9PubMedCrossRefGoogle Scholar
  40. 40.
    Gibbons L, Blair SN, Kohl HW, et al. The safety of maximal exercise testing. Circulation 1989; 80: 846–52PubMedCrossRefGoogle Scholar
  41. 41.
    Mittlemann MA, Maclure M, Toiler GH, et al. Triggering of acute myocardial infarction by heavy physical exertion. Protection against triggering by regular exertion. New Engl J Med 1993; 329: 1677–83CrossRefGoogle Scholar
  42. 42.
    Carroll JF, Pollock ML, Graves JE, et al. Incidence of injury during moderate- and high-intensity walking training in the elderly. J Gerontol 1992; 47: M61–M66PubMedGoogle Scholar
  43. 43.
    Kilbom A, Hartley LH, Saltin B, et al. Physical training in sedentary middle-aged and older men. Scand J Clin Lab Invest 1969; 24: 315–22PubMedCrossRefGoogle Scholar
  44. 44.
    Pollock ML, Carroll JF, Graves JE, et al. Injuries and adherence to walk/jog and resistance training programs in the elderly. Med Sci Sports Exerc 1991; 23: 1194–200PubMedGoogle Scholar
  45. 45.
    Biener K, Buhlmann H. Sports behaviour and sports accidents in old age. Dtsch Z Sportmed 1984; 6: 210–5Google Scholar
  46. 46.
    DeHaven KE, Lintner DM. Athletic injuries: comparison by age, sport, and gender. Am J Sports Med 1986; 14: 218–24PubMedCrossRefGoogle Scholar
  47. 47.
    Hogan D, Cape R. Marathoners over sixty years of age: results of a survey. J Am Geriatr Soc 1984; 32: 121–3PubMedGoogle Scholar
  48. 48.
    Kallinen M, Alen M. Sports-related injuries in elderly men still active in sports. Br J Sports Med 1994; 28: 52–5PubMedCrossRefGoogle Scholar
  49. 49.
    Kannus P, Niittymäki S, Järvinen M, et al. Sports injuries in elderly athletes: a three year prospective, controlled study. Age Ageing 1989; 4: 263–70CrossRefGoogle Scholar
  50. 50.
    Kavanagh T, Shephard RJ. The effects of continued training on the aging process. Ann N Y Acad Sci 1977; 301: 656–70PubMedCrossRefGoogle Scholar
  51. 51.
    Kavanagh T, Lindley L, Shephard R, et al. Health and sociodemographic characteristics of the masters competitor. Ann Sports Med 1988; 4: 55–64Google Scholar
  52. 52.
    Koplan JP, Powell KE, Sikes RK, et al. Epidemiologie study of the benefits and risks of running. JAMA 1982; 248: 3118–21PubMedCrossRefGoogle Scholar
  53. 53.
    Korpi J, Haapanen A, Svahn T. Frequency, location, and types of orienteering injuries. Scand J Sports Sci 1987; 9: 53–6Google Scholar
  54. 54.
    Lane NE, Bloch DA, Wood PD, et al. Aging, long-distance running, and the development of musculoskeletal disability: a controlled study. Am J Med 1987; 82: 772–80PubMedCrossRefGoogle Scholar
  55. 55.
    Matheson GO, MacIntyre JG, Taunton JE, et al. Musculoskeletal injuries associated with physical activity in older adults. Med Sci Sports Exerc 1988; 21 379–85Google Scholar
  56. 56.
    Peterson M, Renström P. Sports medicine. Läkartidningen 1977; 77: 3613–30Google Scholar
  57. 57.
    Shephard RJ, Kavanagh T, Mertens DJ, et al. Personal health benefits of masters athletics competition. Br J Sports Med 1995; 29:35–40PubMedCrossRefGoogle Scholar
  58. 58.
    Marti B, Vader JP, Minder CE, et al. On the epidemiology of running injuries. The 1984 Bern Grand-Prix study. Am J Sports Med 1988; 16: 285–94PubMedCrossRefGoogle Scholar
  59. 59.
    Sandelin J. Acute injuries requiring hospital care. Br J Sports Med 1986; 20: 99–102PubMedCrossRefGoogle Scholar
  60. 60.
    Jackson RW. The masters knee — past, present, and future. In Sutton JR, Brock RM, editors. Sports medicine for the mature athlete. Indianapolis: Benchmark Press Inc., 1986; 319–28Google Scholar
  61. 61.
    Kvist M. Achilles tendon injuries in athletes. Ann Chir Gynaecol 1991; 80: 188–201PubMedGoogle Scholar
  62. 62.
    Barfred T. Achilles tendon rupture. Aetiology and pathogenesis of subcutaneous rupture assessed on the basis of the literature and rupture experiments on rats. Acta Orthop Scand 1973; 152: 1–124Google Scholar
  63. 63.
    Klasen HJ. Acute soccer injuries. Int J Sports Med 1984; 5: 156–8CrossRefGoogle Scholar
  64. 64.
    Biener K, Hälg A. Ballgame accidents. Dtsch Z Sportmed 1982; 5: 156–61Google Scholar
  65. 65.
    Lane NE, Bloch DA, Jones HH, et al. Long-distance running, bone density, and osteoarthritis. JAMA 1986; 255: 1147–51PubMedCrossRefGoogle Scholar
  66. 66.
    Batt ME. A survey of golf injuries in amateur golfers. Br J Sports Med 1992; 25: 63–5CrossRefGoogle Scholar
  67. 67.
    Jobe FW, Perry J, Pink M. Electromyographic shoulder activity in men and women professional golfers. Am J Sports Med 1989; 17: 782–7PubMedCrossRefGoogle Scholar
  68. 68.
    Kujala UM, Kaprio J, Sarna S. Osteoarthritis of weightbearing joints of lower limbs in former elite male athletes. BMJ 1994; 308:231–4PubMedCrossRefGoogle Scholar
  69. 69.
    Marti B, Knobloch M, Tschopp A, et al. Is excessive running predictive of degenerative hip disease? Controlled study of former elite athletes. BMJ 1989; 299: 91–3PubMedCrossRefGoogle Scholar
  70. 70.
    Vingård E, Alfredsson L, Goldie I, et al. Sports and osteoarthrosis of the hip. An epidemiologic study. Am J Sports Med 1993; 21: 195–200PubMedCrossRefGoogle Scholar
  71. 71.
    Hulkko A, Orava S. Stress fractures in athletes. Int J Sports Med 1987; 8: 221–6PubMedCrossRefGoogle Scholar
  72. 72.
    Jackson RW, Rouse DW. The results of partial meniscectomy in patients over forty years of age. J Bone Joint Surg Br 1982; 64B: 481–5Google Scholar
  73. 73.
    Kvist M. Achilles tendon injuries in athletes. Sports Med 1994; 18: 173–201PubMedCrossRefGoogle Scholar
  74. 74.
    Hackney RG. Nature, prevention, and management of injury in sport. BMJ 1994; 308: 1356–9PubMedCrossRefGoogle Scholar
  75. 75.
    Strauss RH, editor. Sports medicine. Philadelphia: WB Saunders, 1991Google Scholar
  76. 76.
    Safran MR, Seaber AV, Garrett Jr WE. Warm-up and muscular injury prevention: an update. Sports Med 1989; 8: 239–49PubMedCrossRefGoogle Scholar

Copyright information

© Adis International Limited 1995

Authors and Affiliations

  • Mauri Kallinen
    • 1
  • Alen Markku
    • 1
  1. 1.Peurunka — Medical Rehabilitation and Physical Exercise CentreLaukaa ASFinland

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