Do you hobble when you get out of bed or up from the couch? Do you have trouble tying your shoes or raising your arm high enough to reach a high shelf? You're probably experiencing an age-related decline in elastin, the protein that gives muscles, ligaments and tendons their elasticity.
It's normal to experience short-lived and intermittent stiffness, such as when you change position. It's also normal to be stiff for a few minutes when you get up in the morning.
Reason: The gel phenomenon. Fluids accumulate in and around joints when you sleep. This extra fluid volume, known as gelling, impairs muscle and joint movements until it dissipates with movement.
When to worry: Persistent stiffness...discomfort in the absence of movement...and/or pain or stiffness in multiple locations can indicate arthritis. Anyone who is always stiff should get checked by a rheumatologist.
Some people naturally produce high levels of elastin. They may retain full mobility throughout their lives. Most people, however, start experiencing a noticeable decline in elastin and an increase in stiffness in their 50s or 60s. Past injuries can be a factor. Someone who tore a hamstring while skiing, for example, will probably develop fibrosis (tissue scarring) that eventually will make him/her less flexible.
Everyone recognizes the muscle/joint pain that occurs from overuse--from working all day in the yard, for example, or from playing three hours of tennis when you usually stop at two. Most stiffness, however, is due to lack of use. A lack of exercise causes a decline in connective tissue flexibility.
To gain more flexibility, try any of the following options.
- Yoga. I recommend yoga because it's one of the more efficient stretching exercises. The graduated lessons (from novice to intermediate and advanced) allow people to improve their range of motion without risking overuse injuries. Yoga elongates and relaxes muscles and stimulates the flow of lubricating fluid in the joints. Most health clubs and recreation/senior centers offer yoga classes. A style known as hatha yoga is ideal because it emphasizes slow, gentle stretches, along with breathing and other relaxation techniques.
- Bed stretches. People who are stiff first thing in the morning might want to stretch for a few minutes before getting out of bed. This helps remove excess fluid from joints and can reduce morning aches and creakiness.
Example: Raise your arms overhead and toward the headboard-hold the stretch for about 10 seconds. Then extend your toes toward the footboard to stretch the feet and ankles. You also can clasp your hands under your knees, one at a time, and gently pull each toward your chest.
- Weight training. We lose about 1% to 2% of our muscle strength every year after about age 50. Declines in muscle strength increase the risk for joint damage and stiffness.
Self-test: Sit in a straight-backed chair, and try to stand up and sit down without using your arms. Most people can do it at least five times. If you can't do it even once, you need to build more muscle strength.
Work with a trainer to design an exercise regimen that strengthens your abdominals, back, chest, thighs, shoulders and hips.
Example: Wall squats to strengthen the thighs. Stand with your back against a wall, with your feet about two feet out from the wall and your arms extended in front of you. Bend your knees and slowly squat, keeping your back supported against the wall. Try to lower yourself until your thighs are parallel to the floor, then slowly return to a standing position.
- New mattress. Most mattresses wear out in about seven years—yet many people keep the same sagging mattress for decades. If you're waking up with back stiffness, you might need a new mattress. Look for a mattress that's moderately firm, with a thin pillowtop that allows you to sink in slightly.
Also important: A firm pillow that's just thick enough to hold your head in line with your spine. A lot of my patients with neck stiffness use extra-large pillows that push the head almost on top of the chest.
- Glucosamine. Derived from the shells of shellfish, this supplement is reputed to repair and strengthen cartilage. In Europe, where glucosamine is given by prescription, it's widely believed that glucosamine reduces hip and knee stiffness, but research has been mixed. Some studies, particularly those looking at arthritis and stiffness of the hands and spine, indicate that glucosamine is not effective for cartilage in these areas.
My advice: Take 1,500 milligrams (mg) of glucosamine daily for eight to 12 weeks. If your stiffness/pain does not improve by then, the supplements probably won't help you.
Caution: Check with your doctor before taking glucosamine if you are allergic to shellfish.
- Fish oil. Patients with joint stiffness from rheumatoid arthritis or other inflammatory conditions may improve when they take fishoil supplements. Many studies have shown that fish's omega-3 fatty acids can reduce systemic inflammation. They're less likely to be effective for inflammation caused by osteoarthritis
Dose: The standard advice is to take 1 gram (g) to 2 g daily. However, you might have to take 5 g or more to achieve significant benefits for inflammatory conditions. Side effects may include diarrhea and nausea.
- Acetaminophen. The painkiller acetaminophen is less likely than ibuprofen or aspirin to cause stomach upset, and it's just as effective in patients with noninflammatory pain and stiffness. Take 325 mg to 650 mg every four to six hours, but don't take it for more than 10 days unless directed by your doctor.
An extended-release formula, such as Tylenol Arthritis Pain, can be effective for morning stiffness. Take it when you go to bed. The drug stays active throughout the night and can help you move more easily first thing in the morning.