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Running Over 35: Using Acupuncture and Herbal Medicine for Longevity

Updated: 22 hours ago

Thirty-five isn't some biological cliff you fall off, but it can feel that way. The starting point is a little different for everyone, but there are biological changes that do start happening. Beyond musculoskeletal, inflammation becomes a concern for everyone, and hormones have their own special impact as well. For those who have been athletes in life, the road may not be bleak, but there's a little something for everyone.


What happens to our body over 35?

Let's start with looking at cardio: Peak endurance performance is maintained until around age 35, after which a progressive decline in VO2max becomes the primary driver of slowing endurance capacity. In other posts we've discussed various biological processes that contribute to musculoskeletal pain attributed to aging. A key factor we identified in those contexts is inflammation.


Here's the part that should actually cheer you up and should be very interesting:

World record performances from master athletes show an essentially linear decline with age until around the eighth decade of life, after which the rate of decline accelerates. The researchers behind that data argue this pattern reflects normal, healthy aging rather than disease, and that much of what gets blamed on age in typical research is really the confounding effect of reduced activity rather than age itself. With (peri)menopause becoming central to the discussion, datapoints included genders, men and women, and ages ranged up to mid to late seventies. A couple of key things-- 1. This is an ode to another discussion: "Define Couch" These are high performing athletes. The genetics could be different. Certainly, the lifestyle will likely be different than the average person or average serious runner. 2. The sporting events varied. But, what this still could imply is that with the best practices in place, athletic life may be different with age, but it doesn't have to be a drop-off.


Muscle holds up better than people expect, too, but with the right lifestyle practices. Chronic exercise training preserves muscular strength and physical function in older adults at levels approaching those of much younger, healthy individuals. Tendons are a bit different: tendon stiffness and elastic modulus decline fairly consistently with age, yet tendons retain meaningful responsiveness to training, adapting to targeted loading in older adults by magnitudes similar to younger adults over 12 to 14 weeks. The crossectional area-- fancy word for size-- showed a lot of variance in the linked review. The impact of this variance is still unclear, but keep in mind, a tendon-friendly training program could increase the volume of tissue, but it may not change what it can handle. This is genuinely an area still being teased out.


Then, there's the quieter one nobody used to bring up at the start line: inflammation. Chronic low-grade inflammation often attributed to aging itself may be better explained by reduced physical activity than by chronological age, since exercise training has its own measurable anti-inflammatory effects substantial enough that researchers have proposed renaming the phenomenon "inflamm-inactivity" rather than "inflamm-aging." Translation: a decent chunk of what gets pinned on turning 35 could actually just what happens to a body that stops moving as much!


One disclaimer I would add clinically is that inflammation has some frequent flyers, but inflammation encompasses many, many chemical pathways and downstream effects. As research begins to include female anatomy and wider age ranges, the biodiversity in these pathways may be critical to understanding how true the inflamm-inactivity hypothesis is.


What does this mean for running?

None of this adds up to "give up." It adds up to "the margins get thinner." Your endurance ceiling lowers gradually rather than collapsing, and stays well above a sedentary baseline as long as you keep training. Tendons likely still adapt to load the same way they always did, so the work you're putting in still counts.


Where it gets trickier is what happens after an actual injury, rather than during normal training. In mouse models, aging didn't meaningfully change tendons' baseline mechanical properties, but it significantly impaired their ability to heal after an acute injury, with notably lower strength and stiffness in repairs from older tissue. That's animal data, not a guarantee about your shin, but it lines up with something most over-35 runners already suspect from experience: the injury itself might not be worse, but the comeback takes longer than it used to. The limited human research available on recovery kinetics after exercise similarly suggests recovery may slow somewhat with age, though the evidence base here remains thin and far from settled.


How you run also matters! Running is different from jogging. Jogging is different from walking. A hard hitting heel striker is going to have a completely different impact on their joints than a forefoot striker in barefoot shoes with ample muscle built for the load. AND your recovery and how you feel afterward will be significantly different.


A Summary and a Gift

If you have top notch training practices, you may find that training the same way works for you, but if you feel like your body is taking a hit you didn't feel with the same training in the past, remember the recovery stakes are higher now. It may have always been an issue; you just might be feeling more now. Treat it as a gift that you can hear your body more now than in the past and adjust accordingly.



Can acupuncture and herbal medicine help?

This is exactly the kind of gap acupuncture is suited to close, not because it reverses aging, but because it targets the two specific variables aging actually changes: background inflammation and recovery speed.



What about herbs?

A handful of herbs show up over and over in this research: Astragalus, Eucommia, Cordyceps among them. Rather than list all of them and leave you to sort it out, here's the one whose evidence actually matches the question this post is asking, which is what happens specifically to people in this age range, not to 22-year-old competitive cyclists.


A 12-week double-blind, placebo-controlled trial in adults aged 50 to 75 found that Cordyceps sinensis (Cs-4) supplementation significantly improved the metabolic and ventilatory thresholds that determine how long endurance effort can be sustained before fatigue sets in, increasing them by 10.5% and 8.5% respectively. Worth being precise here: VO2max itself didn't change in that trial, just the thresholds that govern how usable that VO2max actually is during a real effort, which is arguably the more relevant number for a runner anyway.


It's also worth saying the evidence isn't uniformly glowing. Trials in younger, already highly-trained cyclists have found no benefit from the same supplement, which suggests whatever Cordyceps is doing, it's doing for people whose systems have more room to respond, not for athletes already sitting near their physiological ceiling. That's good news for this particular audience, since it's the trial in the age-matched population that came back positive.


In TCM terms, Cordyceps has traditionally been used as a Jing-supporting tonic, the kind of herb reached for when the goal is restoring underlying vitality rather than treating one acute complaint, which tracks reasonably well with what the modern research is describing. If you're considering adding it, loop in whoever manages your other medications first. Quality and dosing vary a lot between products, and that's not a detail worth guessing on.

Key takeaways

  • Endurance capacity gradually declines after about age 35, primarily driven by VO2max, but training keeps that decline well above what a sedentary body experiences.

  • Muscle strength and tendon adaptability both hold up better with continued training than most people assume.

  • The real shift isn't how hard you can train, it's how long things take to heal and recover afterward.

  • Acupuncture has measurable evidence for reducing inflammatory markers and speeding muscle soreness recovery, both aimed squarely at the two things that actually change with age.

  • Of the herbs studied here, Cordyceps sinensis has the most directly relevant evidence, specifically in adults in this age range rather than in young elite athletes.

 

Dr. Diane Stanley is a doctor of acupuncture and Chinese medicine. Blog content is for informational and educational purposes only and does not constitute medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider before making changes to your health routine.


References

  1. Tanaka H, Seals DR. Endurance exercise performance in Masters athletes: age-associated changes and underlying physiological mechanisms. Journal of Physiology. 2008;586(1):55-63. https://doi.org/10.1113/jphysiol.2007.141879

  2. Lazarus NR, Harridge SDR. Declining performance of master athletes: silhouettes of the trajectory of healthy human ageing? Journal of Physiology. 2017;595(9):2941-2948. https://doi.org/10.1113/JP272443

  3. McKendry J, Breen L, Shad BJ, Greig CA. Muscle morphology and performance in master athletes: A systematic review and meta-analyses. Ageing Research Reviews. 2018;45:62-82. https://doi.org/10.1016/j.arr.2018.04.007

  4. McCrum C, Leow P, Epro G, et al. Alterations in Leg Extensor Muscle-Tendon Unit Biomechanical Properties With Ageing and Mechanical Loading. Frontiers in Physiology. 2018;9. https://doi.org/10.3389/fphys.2018.00150

  5. Flynn MG, Markofski MM, Carrillo AE. Elevated Inflammatory Status and Increased Risk of Chronic Disease in Chronological Aging: Inflamm-aging or Inflamm-inactivity? Aging and Disease. 2019;10(1):147-160. https://doi.org/10.14336/AD.2018.0326

  6. Ackerman JE, Bah I, Jonason JH, et al. Aging does not alter tendon mechanical properties during homeostasis, but does impair flexor tendon healing. Journal of Orthopaedic Research. 2017;35(12):2716-2724. https://doi.org/10.1002/jor.23580

  7. Borges NR, Reaburn P, Driller M. Age-Related Changes in Performance and Recovery Kinetics in Masters Athletes: A Narrative Review. Journal of Aging and Physical Activity. 2016;24(1):149-157. https://doi.org/10.1123/japa.2015-0021

  8. Shi GX, Tu JF, Wang T, et al. Effect of Electro-Acupuncture (EA) and Manual Acupuncture (MA) on Markers of Inflammation in Knee Osteoarthritis. Journal of Pain Research. 2020;13:2171-2179. https://doi.org/10.2147/JPR.S256950

  9. Huang C, Wang Z, Xu X, et al. Does Acupuncture Benefit Delayed-Onset Muscle Soreness After Strenuous Exercise? A Systematic Review and Meta-Analysis. Frontiers in Physiology. 2020;11. https://doi.org/10.3389/fphys.2020.00666

  10. Chen S, Li Z, Krochmal R, et al. Effect of Cs-4 (Cordyceps sinensis) on Exercise Performance in Healthy Older Subjects: A Double-Blind, Placebo-Controlled Trial. Journal of Alternative and Complementary Medicine. 2010;16(5):585-590. https://doi.org/10.1089/acm.2009.0226

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