Sarcopenia: Rethinking Normal Aging! Why “Getting Older” Isn’t the Real Problem
By Dr. John Mishock, PT, DPT, DC
As we age, many people accept a gradual decline in strength, balance, and mobility as inevitable. Slower
walking, difficulty rising from a chair, joint pain, and fear of falling are often chalked up to “just getting older.” But growing medical evidence tells a different story. Much of what we attribute to aging is actually the result of a treatable condition known as sarcopenia. Sarcopenia is a progressive loss of skeletal muscle strength, quality, and mass. While it becomes more common with age, it is not a normal or unavoidable part of aging. Instead, it is now recognized as a systemic disorder with wide-ranging effects on the entire body.
Muscle: More Than Movement
Traditionally, muscles have been viewed as a system responsible for movement and posture. Modern science now tells us that skeletal muscle is also a metabolically active endocrine organ. Muscle tissue releases signaling molecules known as myokines, which act as chemical messengers throughout the body. These myokines play a vital role in communication between muscle and major organ systems, including the brain, heart, liver, pancreas, lungs, and immune system. Healthy muscle function helps regulate blood sugar control, inflammation, cardiovascular health, cognitive function, and even mood.
When muscle mass and quality decline, this communication network is disrupted. The result is not just weakness, but broader systemic consequences such as increased inflammation, insulin resistance, reduced cardiovascular efficiency, and impaired neurological function. In this way, sarcopenia contributes not only to musculoskeletal problems, but to overall declines in health and resilience.
Why Muscle Loss Accelerates Pain and Degeneration
Muscle is also the body’s primary stabilizer. Strong muscles protect joints, support the spine, absorb shock
during walking, and maintain balance. When muscle deteriorates, joints and connective tissues are exposed to
higher mechanical stress.
Research shows that sarcopenia contributes directly to:
• Increased falls and fractures
• Accelerated bone density loss (osteoporosis)
• Joint degeneration and osteoarthritis
• Chronic neck and back pain
• Reduced endurance and independence
• Longer recovery times after illness or surgery
When muscle loss and bone loss occur together—a condition known as osteosarcopenia—the risk of serious injury and loss of independence rises dramatically.
The Joint–Muscle Feedback Loop
Weak muscles fail to stabilize joints properly, accelerating cartilage breakdown. In turn, joint pain leads to reduced movement, which further worsens muscle loss. This creates a self-perpetuating cycle: pain leads to inactivity, inactivity leads to muscle deterioration, and muscle deterioration leads to more pain and instability in the spine, knees, hips, and ankles. Treating pain alone, without restoring muscle strength and coordination, often results in incomplete or temporary relief.
How Sarcopenia Is Identified
Physical therapists use muscle strength and function testing to identify muscle health. Simple tests such as grip strength, muscle strength testing, sit-to-stand performance, walking speed, and balance assessments can reveal early deficits long before severe disability occurs.
The Good News: Sarcopenia Is Treatable
Unlike many age-related conditions, sarcopenia responds remarkably well to the right interventions. Progressive resistance training is the gold standard, shown to improve muscle strength, muscle quality, metabolic health, and functional performance at virtually any age.
At Mishock Physical Therapy, treatment goes far beyond generic exercise programs. Care is individualized and focuses on:
• Progressive strength training matched to ability
• Improving neuromuscular activation and coordination
• Enhancing balance and fall prevention
• Restoring joint stability and spinal support
• Re-establishing confidence in movement
Nutrition also plays a supporting role. Adequate protein intake and nutrients such as vitamin D and leucine help support muscle repair and adaptation. However, nutrition alone is insufficient—muscle requires mechanical loading to improve.
Rethinking “Normal” Aging
Perhaps the most important takeaway is this: many of the limitations people accept as “normal aging” are not inevitable. Muscle health is a primary driver of mobility, independence, metabolic health, and longevity. Treating joint pain, bone loss, or balance problems without addressing underlying muscle deterioration is like repairing surface damage without reinforcing the structure beneath it. Long-term solutions require restoring strength, stability, and communication across the entire musculoskeletal system.
We can help!
If pain is limiting you from doing the activities you enjoy, give Mishock Physical Therapy a call: locations in Gilbertsville (610-327-2600), Skippack (610-584-1400), Phoenixville (610-933-3371), Boyertown (610- 845-5000), Limerick (484-948-2800) at www.mishockpt.com or request your appointment by clicking here.
Dr. Mishock is one of only a few clinicians with doctorate-level degrees in both physical therapy and chiropractic in the state of Pennsylvania. He has also authored two books; “Fundamental Training Principles: Essential Knowledge for Building the Elite Athlete”, “The Rubber Arm; Using Science to Increase Pitch Control, Improve Velocity, and Prevent Elbow and Shoulder Injury” both can be bought on Amazon or train2playsports.com.
