Masters Athletes and Staying Active After 40

Osteoarthritis is not a reason to stop

Radiographic osteoarthritis is common from midlife onwards and correlates poorly with symptoms — many people have changes on imaging and no pain, and some have significant pain with modest changes. A diagnosis of osteoarthritis is not a prognosis and it is not an instruction to stop exercising.

Exercise is the best-evidenced treatment for symptomatic knee and hip osteoarthritis, and appropriately loaded activity does not accelerate joint damage. What generally needs adjusting is the distribution of load — how much impact, how much volume, how it is progressed — rather than whether you participate at all.

Tendons after 40

Tendinopathy in a masters athlete tends to be slower to settle, more sensitive to sudden increases in volume, and more likely to be sitting on a background of reduced capacity rather than a single training error. It still responds to progressive loading — it just needs a longer runway and less tolerance for the stop-start pattern of training hard when it feels good and stopping when it flares.

This is also the group in which adjuncts are most often considered, and where being clear about the evidence matters most. Shockwave therapy has reasonable support in chronic tendinopathy when combined with loading. Platelet-rich plasma has a mixed and heterogeneous evidence base that varies considerably by tendon and by protocol. You should expect to be told which of those applies to your problem, including when the honest answer is that the evidence is weak.

Bone health is part of the picture

A low-trauma fracture after 50, a marked loss of height, long-term corticosteroid use, early menopause or a strong family history are all reasons to consider bone density assessment rather than treating a fracture as bad luck. Bone stress injuries in older endurance athletes deserve the same consideration.

Resistance training and impact loading are among the few interventions that positively influence bone, which is another argument against the reflexive advice to switch everything to swimming and cycling.

Setting the goal properly

The clinically useful question is not whether your imaging looks like a 25-year-old's. It is what you want to be able to do, what is currently limiting that, and which of those limits are modifiable. Some are. Some are not, and being told plainly which is which is more useful than optimism.