Stepping Down Harder at 70+? Why?

Feeling stupid on a step!

At 81 I look back at all those old ladies with dodgy knees, who were sent into our Physiotherapy department and I cringe.

‘It’s alright going up, but coming down is the problem.’ was a common complaint.

If you are over 70 you may already be saying it yourself.

Young JW of course knew straight away what the problem was. ‘We just need to get your knee muscles stronger,’ said that confident young person reassuringly.

My advice didn’t work. Blame the patient for not doing their exercises, of course!

I now know I was wrong. I didn’t know then what I know now. I had no idea what Knees feel like at 80. I certainly hadn’t a clue what the ladies were trying to explain.

Now my Knees tell me every day. And it is exactly the same message: Going down steps starts to feel difficult as you age.

Note! I said feels. And it is that feeling which is hard to explain to anyone who has not yet experienced it.

Ancient GW tries to describe it.

There you are, a happy 80-year old setting off across a park taking the Knees for their daily. They are protesting as usual, of course, but willing. A promise of only a mile or two, probably 30 minutes, reassures them. Lovely day, so off we go.

All’s well until you spot a view point. Curiosity (one of the great pleasures you have time for in old age) says we must go and take a look. Of course. Only a few steps up we tell the Knees, and there we are, all of Glasgow at our feet. Beautiful skyline, well worth it. Enjoy! Turn to go back.

Ah …here it is, the problem the patients talked about.

Deep steps back down.

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The Knees start getting scared, you can tell. Help needed. Look around, no hand rail. Didn’t bring a stick. Now what? You stand on the edge of the top step. It is only 9 inches high for heaven’s sake.

But the Knees have now gone into total panic mode. NO!

You gingerly put an encouraging foot forward, but the Knees have frozen. No way are they going to let go. You can hear their scream … ‘No, we will collapse! Don’t do it! You’ll fall …’

They win. It is ridiculous. You feel ridiculous. You are a mature adult and you can’t tell your own Knees what to do! You stand there frozen, and look round to see if anyone is watching this nonsense. Start smiling as if you are just admiring the view. But you still can’t step down. Stuck.

 And that’s exactly what the patients were saying: ‘My Knees feel as though they will let me down’. They were so right. Though now, literally being in their shoes, I realise that it is actually the opposite, the Knees won’t let me down. The ability to do a controlled bend has vanished!

Most of us Oldies agree, the knees start panicking in our early 70s.  You discover that, going down steps with no rail, you start to clutch at straws! Yes, I mean that. You do it without thinking.

‘I can get down OK if I hold onto a few twigs ……How bizarre is that to tell anyone? Except to giggle with your peers. Sounds stupid, looks stupid, feels stupid.

Interestingly, nobody tells any of us Oldies what to do. It just happens, independently, to us all.

So what is going on?

It isn’t strength, or rather, not entirely so. Research is confirming the real problem. It is a gradual failure in your sensory mechanisms. Only a slight one, but the reflexes which control balance and slow lowering are missing some information so cannot react as they did.  Marvellous things our bodies, quick adjustment needed, so hand out and reach for something to substitute. All the reflex needed was a bit more accurate idea of where your body is in space.  And amazingly just touching something external is enough.  We clutch at straws! Or touch a wall, anything.

See my blog on balance. A similar problem happens as you get older when you close your eyes.

Fortunately research is also showing that balance exercises, dance, Tai Chi …..any activity where you practice controlling a wobble is helpful for improving and staving off.

Why have I written this?

I want to ask two questions:

1. Is it possible to really understand how it feels to be in an ageing body until you have tried it? I am beginning to doubt it! And, if not, does it matter? I think it does.

2.  Without this understanding, can the medical professions genuinely tackle the problem? Is research hitting the real causes of these problems of an ageing body?

Perhaps we should be saying more clearly what is happening to us and asking why? Over to you!

9 Comments

  1. September 18, 2017 / 8:42 am

    Hi. I love your posts and yes, the knees! On a slightly different tangent I know you often talk/write about how might older people influence the professions. Do you read the British Gerontology Society’s blog? Here’s it’s latest https://britishgeriatricssociety.wordpress.com/2017/09/15/the-second-bgs-cultural-revolution-and-the-living-well-sig/

    Do you notice from this (at the bottom) that they’re asking people to register their interest in a Living Well Special Interest Group (otherwise known as the SIG). I’m just about to send an email saying would you consider an ordinary older person, albeit one of those old-fashioned things, an SRN. I think you should do the same!!!! Well I think there’s nothing to lose. But professionals don’t realise when they’re young what it is to be old – it’s all conjecture and of course research, but that’s not quite the same!!!

    Yes, I am going to send an email to them!

  2. rinaross
    September 18, 2017 / 11:45 am

    Thanks for this. The more we share our experiences the more ‘normal’ we feel . At 82 I experience this problem with stairs without handrails, but did not associate this with knees. I have the same feeling of insecurity when faced with a down slope, however shallow. On walks with friends, I am known for grabbing people’s hand .

    • September 18, 2017 / 4:13 pm

      Thank you for that. If you look at Twitter you will see I have quoted you! So helpful to have comments.
      Yes, it is lack of control in your knees, slow lowering that makes you fell scared and clutch. But don’t stop! Train your friends to put a hand out and scream at anyone who has failed to provide a hand rail!

  3. September 18, 2017 / 9:26 pm

    Interesting information. I am only 65 but can identify with this feeling. A couple of years ago I fell down some stairs at my workplace. No permanent damage but ever since I have a fear or trepidation whenever descending stairs. I have to force myself if there is no handrail or wall. Recently travelled to usa and did a lot of walking up and down mountain steps and also downhill slopes where the same feelings occur. Lets not let this natural progression in life stop us from exploring. Ask for someones hand and lets not feel stupid about something that is normal.

  4. September 19, 2017 / 9:38 am

    Actually on reflection I do find it very difficult go down stairs our steps without a handrail. And yes, I have to grasp onto anything including grass!

  5. eremophila
    September 19, 2017 / 10:50 am

    When out bushwalking I much prefer to have a hiking stick with me just for the added confidence it gives when going up or down. I know my reflexes are slower now esp when tired and the last thing I need is to be stranded out bush.
    It comes down to walking in another’s shoes once in a while. Young medicos could be strapped into devices which simulate an aging body. There was that great movie years ago with William Hurt who played a doctor who got cancer and then experienced what it was like the be a patient.

  6. Paul
    September 23, 2017 / 6:58 am

    Do we feel that this can be attenuated and improved on with some slow descending training (sit-downs etc), or is it something that we will just have to deal with…

    • September 23, 2017 / 7:49 am

      Hi Paul

      As a Physio and Having lived with this since my late sixties (as have so many of my friends) you can imagine, I have tried all possibilities including Tai Chi. The latter was helpful and regular practice on less high steps keeps the mechanism operating, but you never get past the feeling of automatically wanting to put your hand out and just touch something! If you don’t it is extremely hard to let go enough to step one foot down past the other. Just feels dangerous, but it isn’t fear that stops you, it is the inability to control the lowering.
      Have decided to campaign for shallow steps and hand rails in all public spheres!

      Best

      Joyce

      From my iPad
      Joyce

      • September 28, 2017 / 3:28 pm

        Yes we are seeing more and more ramps in public places now but they do take up a lot of space.

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