The tight correlation with advancing age probably mainly due to the prevalence of chronic metabolic diseases, not age per se. According to the CDC, the prevalence of metabolic dysfunction in adults 60 or older is 98%.

Advanced Glycation End-Products (AGEs), IMO, are 1ry culprit
Glycation, or the non-enzymatic binding of sugar molecules (mainly glucose & fructose, of which fructose vos the worst villain) to proteins m, cause thickening and stiffening of tissue.
With the loss of elasticity, sudden eccentric muscle contractions can more easily lead to a tear. This can happen with a fall or attempt to break a fall. Some forced activities of daily living can cause it, too. In some patients no such history is even present.

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More from @moreyraortho

31 Dec 20
And glycation reduces elasticity of soft tissues, including arterial walls. This, in turn, would lead to decreased vessel compliance and decreased visible superficial pulses, probably long before cardiac CT scans would show CAC.
In ortho, Advance Glycation End-Products (AGEs) is quite possibly the #1 reason why we see so many rotator cuff tears, degenerative meniscal tears, quadriceps tendon ruptures, etc in mid to older adults.
The lack of elasticity leads to a rapid increase in tensile stress in eccentric muscle contractions for a given amount of strain and leading to muscle/tendon failure (rupture).
Read 5 tweets
25 May 20
If you want to avoid an orthopedic surgeon at some point in your life, and don’t want lengthy, complicated advice, I have two simple principles:

1. Employ risk mitigation (this is the obvious one) : Wear seatbelts, dont text and drive, etc. (the other is not so obvious)
2. Change your diet to a #lowcarb diet for life. Why? Simple. It addresses the #rootcause or associations in most chronic diseases (obesity, high blood pressure, type 2 diabetes, coronary artery disease, many cancers, benign prostatic hyperplasia, polycystic ovarian syndrome,...
...Non-alcoholic fatty liver disease, dementia, etc) INCLUDING that which leads to joint pain/inflammation and tendon tears. Through a process called glycation, sugars get deposited on soft tissues, leading to Advanced Glycation End-products (AGEs). These AGEs...
Read 10 tweets

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