Fraying at the Edges..


Had no idea how interesting it would be, being a Physiotherapist and watching my own body slide away.

No, not weight loss. Just a steady trickle of small things disappearing as age moves on.

At 82 it is becoming more obvious and I have found it intriguing to realise that much of the loss is quietly and subtly neurological. Wish I had understood that when I was working years ago!

So this is a report on findings from the Far Side of retirement. Maybe I should tell you, that I am increasingly convinced that you cannot truly understand old age until you have tried it! Quite a surprising period of life to live. You learn a lot!

Keeping joints flexible has not yet been a problem, nor has muscle strength diminished seriously…been keeping a firm eye on them….in true Physio tradition.

The new problems seem to involve the loss of reflexes.

Balance reflexes were the obvious ones to go. Not difficult to spot them misbehaving. There were techniques for attempting to hold the slide. Tai chi etc. Maybe not followed as assiduously as they might have been? Whatever, that slide has continued. Uneven ground, cobbles and pebble surfaces are now dodgy…a stick is wise. A flowery folding one?

Do hope landscape gardeners, Park designers and street planners are reading this. Our ageing pop. will need a smooth world! And plenty of seats, stamina is having a slide too.

I have already written about the slow loss of eccentric control in knees and the subsequent loss of the ability to step down without a hand touching something. Not for leaning on I hasten to add. Just touching: an extra proprioceptive input, and it becomes possible.

But another small loss one has arrived, very quietly : a very slight foot drop. Possibly only noticed because as a Physio I began to hear a bilateral foot slap when walking. Nothing otherwise obvious.

Until I put two and two together. Or rather, three and three falls in the past year all due to tripping. A bell rang.

Not sure what the answer is to that. It is not a strength issue, though that is being given the benefit. Am even wondering if anyone else has noticed it and has considered using a form of springy splint? I would be grateful for comments.

It may already be in falls programmes and assessments of older people. But I only noticed it because I was wearing leather soled shoes and could hear it.

A further odd reflex slip has begun recently. An incontinence issue. Not the normal drip when you sneeze or the beware running taps syndrome. I have coped with those, and normally pride myself an an excellent bladder capacity and ability to control until I wish to empty.
Disconcerting therefore to find that on waking in the night with full bladder, an uncontrollable trickle starts as I stand up. Not a lot, but embarrassing and frightening. Presumably the bladder control reflex is not kicking in quick enough or strongly enough to cope with the sudden weight of a full bladder. But rather disturbing to find voluntary control does not replace it. Have of course done the pelvic floor exercises, but it isnt my field. Needs a specialist Physiotherapist?


This is written in the hope that I am talking about things which, although new to me, are already recognised problems in the field of elderly care. I hope so.

If not, then maybe they should be explored?


PS. This piece was originally written for The Chartered Society of Physiotherapy Blog site.  

PPS.  If anyone around my age is reading this, maybe we could compare notes.  

       Suspect  all the professionals working with older people would find it helpful to hear from the far side of retirement.




  1. May 23, 2018 / 6:20 am

    I get notification of the posts on the British Geriatrics Society and I read most of them. I like what they say as most are about how do we better treat and deal with frail older people. But I note something that I don’t like. The posts seem to be very much on the lines of ‘what can we do better (good) for these frail older people, who are obviously not able to help themselves (and from my perspective, that is what is not so good)’ There’s very little about prevention in these posts, because I suppose, it’s all about how to treat the frail when they are frail!!! And then there seems very little about equality there, as in, it’s all about doing things better TO people. Really what I’m getting at is that it all seems very one-sided. Where is there a ‘contract’ between two people (doctor and patient) that together things might get better and if not, OK let’s do it this way. Or, is it that they are writing about people who are never going to recover, and don’t have the capacity to negotiate anyway, hmm.

    I’m writing as a nearly 72-year-old (2 weeks time). I’ve finally found the right class (Pilates) and a Personal Trainer who is setting me up, I think for the rest of my life. Because, although I might have looked fit, I really wasn’t.

    I’m a passionate believer that older people need to take some responsibility for their health, but there is something about the onward march of age, which you’re touching on in your post. What do you think of this? I really do wonder if everyone in danger of falls and continence issues should have several sessions with a physio, and if that is too expensive for the poor old NHS, what about experienced Personal Trainers who would access those muscles that need boosting and reactivating. I really think more emphasis on prevention would save the NHS so much, and also truly these sessions could be very, very useful for older people. And. They could be fun, which is not to be sniffed at! We all need a bit of fun. But yes, let’s be aware of our ageing. There’s no hiding away from it, I think, so let’s face it.

    I think this has stimulated me to write a post on my blog!

  2. Sally Beaumont
    May 23, 2018 / 9:56 am

    Waking in the night has the same outcome.I too do pelvic exercises but no noticeable result. I have tried restricting fluid intake but that too has no immediate result. The same happens whether the bladder is partially full. My immediate problem is cramp and nightmarish dreams which scare me. I wake up, sometimes standing and screaming.
    I am aware of foot drop and of shuffling.
    I find difficulty lifting things, my fingers do not grip so well, ad slip out of my grasp. I am often dizzy and must wait patiently for it to recede All these are signs of ageing!
    I am still here, and enjoying many aspects of life. My “get up and go” is fading a little, unless I am persuaded otherwise.

  3. May 23, 2018 / 10:27 pm

    Great article and very true, well said, “you cannot truly understand old age until you have tried it”. Blessings.

  4. eremophila
    May 26, 2018 / 11:08 am

    Today I discussed similar aspects with a friend, who is still relatively young but is facing declining health for which there is no cure. It’s the mental adjustments that are the most challenging, especially as it’s a hidden disability, And only one who has trodden a similar path has any idea about it.
    The juggle to keep living well despite increasing restrictions.
    It’s a little off topic I know and yet I feel somewhat related.

Leave a Reply