I was reading today an article in the NY Times concerning athletic injuries in aging athletes (http://www.nytimes.com/2010/08/17/health/nutrition/17best.html?8dpc). A thoughtful article, although I am surprised they did not ask the opinion of a non medical style provider. Is being an overachiever athletically a psychological problem? I have been treating older athletes for years. It is always sad when an athlete has numerous injuries that are termed as overuse and then gives up the sport they love because the injuries continue to pile up. I too injured my back playing softball this season and I am likely not to return. Many athletes we treat have chronic problems because they are misunderstood. Stress fractures, knee pain, hip pain, shoulder problems are often looked at as separate entities. The reality is that they are usually part of a gait related issue, causing the person to slam their foot into the ground. It is my experience that most health care providers are trained to look at the pain, name and diagnose the condition and then treat it or put the person on rest for a while then send them back into the wild. The problem is, without understanding the true cause, the next injury occurs, then the next and then the person eventually gives up after years of trying to fight through the eventual outcome of giving up. A better idea is to understand the mechanism of the painful problem, name it functionally vs. using the typical dis ease monicre of itis, osis, tear, stress fracture and realize that functional problems require a functional solution which may include orthotics, gait retraining and other ideas. Most often, these people will likely return to activity and back to the sports they love with far fewer injuries. With the old way of thinking, they may require surgery, joint replacement and other interventions because the doctors were not trained to evaluate why the injuries occurred. Athletes of all ages deserve better. We should never treat or name anything we truly do not understand. Athletes should not suffer because their health care providers do not understand why they hurt. They joint replacement manufacturers will likely not enjoy this blog post however, if you are an aging athlete, for you it will. What do you think. As always, I value your opinions.