Men and Back Pain
This gender gap, as with so many areas in which men and women diverge, is partly a function of biology and partly the result of cultural expectations of male behavior. "I'm convinced that testosterone, competitiveness, and aggressiveness have a lot to do with the way men push themselves past their limits," says Marianne Legato, MD, director of the Partnership for Gender-Specific Medicine at Columbia University in New York City. "Then there's the social conditioning that men get -- that they must suck it up and keep moving in the face of pain. Women, on the other hand, are encouraged to listen to their bodies and to stop if something hurts."
Dr. DiNubile says he treats four times as many men of that generation as women. "The imbalance has to do with the fact that men this age have been playing sports longer and therefore have beaten up their bodies more," he says. "Having experienced injuries as adolescents sets them up for problems down the line in the same parts of their bodies."
Many baby boomer women, in contrast, came of age before the explosion of organized girls' sports (ushered in by Title IX of the Higher Education Act, passed in 1972), and thus were largely spared this sort of wear and tear. But even in adulthood, notes Dr. DiNubile, men and women differ in their approach to physical activity. Women, he says, tend to be more vigilant about stretching, varying their activities, and not overexerting themselves. "At the gym, women are more likely to ask for advice from a trainer," he says, "whereas men, as we know, don't like to ask for directions. Women will do a balanced workout, while men are apt to overwork their 'mirror muscles' -- the biceps, shoulders, and chest. Plus, women are less likely to run out and play a contact sport with someone 10 or 20 years their junior to prove they can still keep up."
Younger men also suffer a disproportionate number of sports-related injuries compared with women, but the musculoskeletal system becomes more vulnerable as one ages. Soft tissues, such as muscles, tendons, and ligaments, become less flexible and more prone to fraying and tearing, and the disks that separate and cushion the vertebrae of the spine begin to degenerate, compromising their ability to protect the back.
Moreover, when injuries occur, an older body requires more time to recover, and recovery may be less than total. The same activity that caused no problems for a 25-year-old may well traumatize the body of a more mature person. And here, too, the psychology of baby boomers and their well-documented reluctance to acknowledge the inevitability of aging come into play. "A guy might think, I used to run five miles a day," says Julie Gilchrist, MD, a sports-injury specialist at the Centers for Disease Control and Prevention, in Atlanta. "But if he hasn't run recently, setting off for a five-mile jog is not a good idea. Yet you'd be surprised how many men do just that."
Indeed, many injuries arise from the so-called "weekend warrior" syndrome. "What I see most are strains and other injuries in guys who sit around all week, then on weekends try to play a sport as if they were 20 again," says Marc Safran, MD, director of the sports medicine program at University of California-San Francisco Medical Center. And when they do hurt themselves, he adds, many men do not seek immediate attention. "Many patients show up only when the pain has become too great for them to go out and play again."
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