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Aging & ArthritisImportant ConceptsPain

I Learned About Stiffness in Anatomy Lab

Farmer Sitting on a Tractor
One of the most common complaints I hear from patients is that they experience pain in transitions; going from sitting to standing, standing to sitting, getting out of chairs, getting out of bed. Now let me say, I never hear that complaint from 20 year olds. I only hear it from those over forty.

 I often recall my old days in medical school anatomy class when my patients ask me why they begin falling apart sometime after forty. I remember so clearly the first day we were “introduced” to our cadavers. It was so amazing on so many different levels, the first and most significant of which was simply the fact that we would now be dealing with human beings. No frogs or pigs. No comparative shark anatomy. Humans. It was a very serious day. Our anatomy professor, spoke with gravity regarding the grace of the donors. And our grace. We worked so intensely with those bodies for a year, they became like a part of our team. They had names. They had lives. Some had surgical scars; no appendices, no uterus,  cancer. Most were old, some young.

About a month into our anatomy class, my partners and I decided to go ask Dr. Daly about our cadaver. We found out his age and his occupation; He was 65, and had been a farmer.

It looked like he had worn a V-necked t-shirt almost every day of his life. He had perfect tan lines on his arms and upper chest. We were allowed a little information regarding our cadavers; no names, just information. He looked old. His tissues were yellowed and hard. Now keep in mind that any corpse preserved in formalin has a degree of yellowing and plasticity to their fat, muscle and organs. But there was a difference in the quality of the soft tissues between one body and another; no different than in life. And the older bodies had hard, thin, yellowed tendons. But the inside of his body looked like all the other septuagenarians and octogenarians; stiff and yellowed. No effects of the sun there.

One of the groups in our class had the cadaver of a young woman who had committed suicide by cutting her wrists. I think they prefer not to use suicide victims in general but there wasn’t a surplus of cadavers and I guess it couldn’t be avoided. It was sad to contemplate and we did contemplate her circumstances, as we did for all of our cadavers.  Then we moved on with our dissections.

But the tissues of the young woman who had committed suicide stood out among all our other cadavers, most of whom had died more naturally during their “golden years.” Hers were softer, more pliable, more rubbery. Not as yellow. The difference was apparent, even in formalin.

Most of the cadavers looked like people I knew. They had soft hands, no ancient tan lines. The appearance of good health even in their fatal repose. But without exception their soft tissues were yellowed, thinned and stiff compared to the young woman who had taken her own life. As you age your soft tissues get toughened, thinned and stiff. They’re in a state of degradation. That’s the point.

And this should be self evident. But for some reason, in the contemplation of our own fragility, it is not. Should the inside of your body, be any different than the outside. Do we not see the gradual degradation of our skin when we look in the mirror? The same process is going on inside us. Remember “The Picture of Dorian Gray.”

So my recommendation, based on the daily complaints I hear from those over forty and based on my cadaveric experiences, is that you begin to develop a habit of doing a little stretching before transitioning from one position to another. After forty.

Now look, you don’t have to do some thirty minute Jack LaLane stretching program every time you get out of your car or out of bed. Just make sure the joints are ready for the transition.

Bend and straighten your knees and your back. You don’t have to pull your ankle around your neck or do a sun salutation. Just bend and straighten your knees. Make sure they’re ready to go where you’re planning to go.

When I’m riding my horse, going around in circles or whatever, I never just take off and make a big sliding stop with my horse. I sort of introduce his body (and his mind) to the fact that we’re going to start making big stops. I do a slow gentle stop first. Then bigger and bigger. That seems logical, doesn’t it?

Frankly, when you’re 60 and you’ve been sitting for an hour, you’ve got to introduce your body to the idea that you’re going to be standing up in a few seconds. Bend and straighten your knees a couple of times. Put your feet on the floor and gently pump them up and down a little.

People are always so surprised that they hurt when they get out of bed in the morning! Think about it. You’ve spent the whole night horizontal to gravity. Most of the night you’ve been curled up in some variation of the fetal position. Now you want your body to just jump up and stand. Hello disagreement.

You can actually hurt yourself getting out of bed. That’s the beginning of the curse of plantar fasciitis for many people. It’s the movement that results in a degenerative meniscus tear for others. So introduce your body to the fact that you’re going to be standing up now. Again, this doesn’t have to be a thirty minute program.

-Roll over onto your back.

-Bend and straighten your knees and hips.

-Rotate your hips in and out.

-Stretch your feet up and down.

-Then turn over on your side, curl up a little and push yourself up into a seated position. This is important. Most of us use our legs and weak abdominal muscles to kind of yank ourselves from a face up position in bed to a seated position. This really aggravates the muscles and joints in your pelvis and back.

– Now wait for a few seconds. Stretch your feet and knees again.

-Then stand.

If you get into the habit of doing this when getting out of bed, I promise it will improve the quality of your rising!

I know that if you try to do more of this kind of quick stretching, and I frankly wouldn’t even go so far as to call if officially stretching… more of an introduction or preparation for what is to come…it will improve the experience of going from one position to another and lessen your likelihood of suffering pain…not all pain…but some.

……………………………………………

And now that I’ve got your attention regarding anatomy lab… Consider donating your body to a medical school. It’s a great way to pay it forward. Your doctors learned anatomy on someone else’s loved one. My mom donated her mom’s body to my medical school. It was a wonderful thing. That summer, after her body had been used to educate medical students, Texas Tech School of Medicine held a memorial service for all the people who had donated the bodies. I guess you would have to say it was for all who had donated their bodies. My whole family went to it. Several medical students spoke, thanking us for the donation. It’s a good thing to do. I remember my cadaver. I learned a lot from my farmer and I thank him for that.

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