Why tendon problems increase with age and how to prevent them

Recently one of my husband’s good friends suffered a ruptured Achilles tendon. One minute he was helping coach his son’s baseball team, the next he took a step and felt it pop.

Yep, a single step was all it took. He wasn’t running. He wasn’t lifting weights. All he did was step forward a few inches and his tendon split in half. Ouch!

We stopped by his house a few days later to check in on him. Surgery had gone well, and he was back in good spirits, joking about how he used to play nine innings without problems, but now that he’s older, all it takes is a step to tear a tendon.

And while it was a joke, there was truth to it…

As we age, we’re far more likely to suffer from tendon issues, ranging from tendinosis (a serious condition where tendons become irritated and have a hard time healing) to full tears that can completely put us out of commission.

Why is that? Can anything be done to keep tendons young and prevent injuries? A new study has the answers.

A low oxygen environment

Previous research had shown that tendon cells change shape under compressive forces, becoming tougher and more like the cartilage in the knee meniscus than like the strong, stretchy material of a healthy tendon. Research had also suggested that as people age, blood supply to tendons decreases, leaving them starved of oxygen.

Yet no one knew which of these events starts the cascade that leads to injury. Researchers at Thomas Jefferson University have now changed all that.

They examined tendon samples from patients who were undergoing surgery for tendinosis and compared tendons from elderly versus young patients to determine what the deciding factor is in the increased risk of tendon problems with age.

And they found that when there are normal oxygen levels around a tendon, its cells are able to retain a normal shape and flexibility. But when those cells were grown in low-oxygen levels, mimicking the low-oxygen environment common in older people, the tendon cells changed shape and became round and more similar to tough cartilage-like cells that are more easily damaged.

In other words, lack of oxygen is the starting point in tendon problems as you get older.

“Our analysis links these two avenues of research, showing that decreased oxygen is a key event that leads tendon cells to go from healthy to tougher and less flexible, resulting in tendinosis,” said surgeon and cell biologist Rowena McBeath, M.D., Ph.D., at the Philadelphia Hand to Shoulder Center at Jefferson Health, who led the study.

Raising oxygen levels to avoid tendon injuries

The good news with all of this is that it shows that you can keep tendons youthful if you can keep the environment around the tendon highly oxygenated.

One way to do this is to make sure they’re getting the blood flow they need to supply that oxygen. Ways to maintain healthy circulation and blood flow include:

Keep moving — Regular physical activity is one of the most effective and easy ways to keep your heart pumping and your blood flowing. You can walk, swim, bike or practice yoga. The possibilities are endless; the only thing that counts is that you stay active.

Eat fatty fish — Research has shown that the omega-3 fatty acids found in fatty fish like salmon, sardines and mackerel help to boost blood flow. Add these foods to your diet and take a quality fish oil supplement daily to supercharge your omega-3 intake.

Increase nitric oxide production — Your body uses nitrates to make nitric oxide in the lining of your blood vessels to dilate them, allowing your blood to flow more easily. Eat nitrate-rich foods like spinach and collard greens and take grape seed extract to activate the nitric oxide.

Tendon problems can lead to serious injuries of your knees, elbows, shoulders and hips as you age. But by using the tips above, you can increase blood flow and supply your tendons with oxygen to prevent these injuries and keep your tendons strong and youthful.