I’d like to think that a sprained finger, bent toe, or even a muscle or ligament tear would encompass the bulk of fitness concerns for folks getting active again. And if you’re restarting after your 4th decade, I hope that musculoskeletal boo boos will be the worst of your worries.
I’ve written about how re-injury becomes more likely when it’s been more than 10 years since you’ve done intense activities like Brazilian jiu-jitsu, heavy weight training, long-distance running, or competitive sports. Most of my last 8 months back on the mat has been about this, as well as the 2 years leading up to it.
Repeatedly getting injured as I restarted, I had to drastically modify my approach, to the extent that Preparing To Re-Enter Intense Athletics became its own special program: identifying specific musculoskeletal vulnerabilities, shoring them up over months with professional help, and testing the program with a return to full-intensity martial arts.
But like the Prince song says, “There’s something else”
And hopefully, it’s not The Afterworld.
It’s everything else. Everything that affects your body and health besides your connective tissue and matters of conditioning. As if the modifications to your exercise regimen weren’t complicated enough.
To be blunt, if you’re 40 or older, your friends have started coming down with major illnesses. Occasionally dying. With increasing frequency as time passes.
This is why many of my blog posts are about Health and Wellness. I started with a focus on getting back on the mat doing all-out martial arts beyond the 5th decade, and pulling a 100-pound warbow. Goals like these demand careful, conscious adjustments due to musculoskeletal changes over time.
But falling over dead counts as the ultimate in forced adjustments. Nothing quite interrupts your grand designs like waking up in the ICU (or Heaven).
To keep doing what we need or love to do, we need to account for more than strains and sprains.
Things that can sidetrack your pursuit of glory
- Infectious disease
- Cardiovascular disease
- Neurodegenerative conditions
A major entry in any of these columns can definitely sideline you. I’ve written about my own 1-2 season long hiatuses due to #brokenbits like muscle and ligament tears, as well as adjustments demanded by the COVID-19 pandemic: many gyms and workout facilities closed for months. And overtraining, cancer, and neurodegenerative conditions like Alzheimer’s, multiple sclerosis, and Parkinson’s Disease, I will address in future posts.
Intense activity can trigger a heart condition, however, so that’s where I’m going to go next.
Cutting to the chase: consult a Cardiologist
It’s like my own roundabout experience with wishing I’d started, rather than finished, with a personal coach. You can try to figure things out on your own, but generally you’ll be symptom-free, and you won’t know what you don’t know. There’s an awful lot involved in figuring out whether you’ve got hidden narrowing in arteries feeding your heart and brain, and the costs of getting it wrong can be prohibitive.
How complicated is atherosclerosis? Not as complicated as immunology — we’ve had immune systems since before we were multicellular organisms — but Peter Attia, one of the smartest physicians I know who blogs like the guy who always placed at the top of his med school class, has a nine-part series on cholesterol alone. With footnotes.
I encourage you to familiarize yourself with his material, but my take homes are the following:
- Atherosclerosis — the narrowing of arteries, especially those feeding important organs like your heart and brain — is a progressive process, like setting aside money for retirement starting in your teen years
- Many factors contribute to it, including cholesterol, blood pressure, genetics, insulin resistance/diet, and tobacco use
- The factors dog pile over the years, but half the major events happen in folks under 60
- 50% of the time, the first sign of significant heart disease is a fatal heart attack
- It’s dang near always the #1 killer in the developed world: about half a million Americans die from it every year
You and I have been setting aside contributions to a very popular atherosclerosis growth fund for the past several decades. Depending on how much you’ve been “contributing” — Overweight or obese? A smoker? High blood pressure? Elevated cholesterol? Stressed? Inactive? Sleep apnea? — your clogged artery fund can have quite the yield by now. Those narrowed arteries don’t need to be fully closed off to cause trouble; a moderate narrowing can develop a crease or crack, causing a clot to suddenly form, which then closes off the artery 100% within seconds.
Translation: you can be entirely symptom-free with high exertion, no trouble with chest pain or breathing, and without warning suddenly need a trip to the ER.
If you have any of the above risk factors in your 4th decade or beyond, it would in my opinion be prudent to get evaluated by a heart doctor before getting too far down the pathway of intense exercise.
Next time: why it makes good sense to weigh your clogged artery risk, even if you’re not planning on Being Batman.