When two aging anglers get together to share fishing stories from the previous year’s fishing, talk about aches and pains is as common as discussions of fish and flies. I see my fellow septuagenarian Peter Pumphrey about once a year up in Lee Vining in June. After I praise him for his stories in California Fly Fisher, we get down to brass tacks and talk about our ailments that get in the way of our fishing.
This year, we thought we could do something useful with our complaining and help others our age to keep fishing. In this article, we touch on a lot of medical conditions afflicting anglers in our age group, male and female. Not all are minor injuries. We offer advice, but no guarantees. I should stress that you should not try to self-diagnose and treat any potentially serious medical problem. Go to the doctor, physical therapist, or chiropractor to get a proper diagnosis and treatment. I have gotten a lot of help from my former general practitioner, with whom I fish now that he has the time, and a physical therapist whom I see more often than I like. What follows are just reflections on the Job-like afflictions that can make fishing difficult and on some of the things that can be done about them or to prevent them.
Muscular Strains and Sprains. Strained and sprained muscles can cause pain in hands, fingers, elbows, ankles, and feet. If minor, they are usually treated by alternating applications of ice and heat for the first 24 hours, plus Ibuprofen or Tylenol. For minor sprains, you usually do not need professional treatment, and after the discomfort subsides, you can do exercises at home or at your gym to help with muscle strength and limberness. For prevention and to minimize recurrences, stretching is the primary focus, either by yourself or in a physical therapy or yoga class.
Ankle Sprains. Minor strains and sprains are one thing, but a sprained ankle can be very serious. It’s easy to underestimate and misunderstand this injury. Some professional athletes lose the season due to a bad ankle sprain. If you are out on the river or some other place away from medical help, try to wrap the ankle as tightly as possible. Then lace up your wading boot tightly, too. My wife once sprained her ankle at the beginning of a backpacking trip several miles from the car. She was determined to go on, so she laced up her hiking boot tightly. Then she soaked her foot for a full day in the first cold water in a nearby lake and laced up the boot again. Her doctor said she did the right thing. To take the weight off the injured side, use a wading staff for balance.
Foot Problems. Foot problems can include plantar fasciitis, arthritic toes, and neuropathy, the latter being nerve damage that can cause pain, numbness, or weakness. With regard to the first problem noted, the plantar area of the foot is the tough, fibrous tissue running from the bottom of the heel bone to the ball of the foot, and fasciitis is when that area becomes inf lamed, which can be quite painful and also cause issues with balance. Try stretches for the plantar area and the application of cold. Surgery is tried occasionally, but even that is not a guaranteed cure. To prevent plantar fasciitis, do plantar stretching before fishing and wear insoles with arch supports in your fishing boots.
Arthritis can really be painful. A painful big toe joint may require surgery to fuse the joint and limit motion. Consult a podiatrist if you want to keep wading, wet or dry. I recommend shoe inserts to prevent arthritic toes from getting worse. You might be able to get your medical insurance to cover that.
Peripheral neuropathy is a symptom and complicated to treat. It might even be related to spinal issues. I had a friend who had neuropathy and diabetes, and he had to keep his feet dry at all costs, because it was easy for him to get infections resulting from poor circulation. He had to wear waders and boots on the hottest of days, even while drifting the lower Sacramento. Whatever the cause of neuropathy, you should practice balance exercises at the gym or at home. You should also strengthen you legs to help with balance.
Knees. Fortunately, I have avoided knee injuries, at least since I broke the knee joint in high school football. Since fishing is not a contact sport, we usually don’t face full tears of the anterior cruciate ligament, which is located deep in the middle of the knee joint and stabilizes the knee as it moves. Orthopedic surgeons can do wonders with arthroscopic repairs.
Sometimes you just need treatment for the meniscus. At any rate, don’t let knee pain go too long. Partially torn ligaments and strained tendons may heal with rehab. I suspect most of us eventually face arthritis in the knees, but a good quadriceps strengthening routine at the gym will help. There’s nothing wrong with using a wading stick all the time, even around a drift boat. You may avoid total knee replacement, but a lot of folks do quite well after them.
Bad Back. Lots of things cause back pain, and lots of things can relieve it. To minimize back issues, stretching before fishing is mandatory. Sometimes a little treatment by a physical therapist or chiropractor who uses stretching, ice, and heat does wonders. Ibuprofen is your friend. You can also try Meloxicam, which is easier on the stomach. Sometimes you can take care of your back simply by slowing down for a week or two. The latest research says that most back pain can be relieved without surgery. In fact, rest, and then moving again is often the best course.
Shoulder Problems. It is hard to avoid shoulder problems as we get older. Rotator cuff tendons simply wear out. If you have torn your cuff by falling down or even by overuse, you may need surgery. Some doctors recommend strengthening the shoulder to help the rotator cuff and avoid surgery. Ibuprofen can reduce the inflammation and pain, but you will need to strengthen the supporting muscles at some point to avoid future problems. I use the same type of stretches for fly caster’s shoulder that are used for swimmer’s shoulder. You can use frozen green peas, headache ice bags, or cold packs from your pharmacy to ice the shoulder, usually the biceps tendon in front of the shoulder. I ice after I fish. I also have a secret weapon, a lacrosse ball that I roll on my back and shoulder blade. Just place the ball between your back and a wall and move it around, hitting trigger points. I know some folks who have gotten relief from cortisone shots, but I think you have to strengthen the shoulder, or you just defer problems. You also need to avoid carrying heavy weights away from the body, such as repeatedly pulling up the anchor in your boat as you move about on the Fall River.
Caster’s Elbow. For caster’s elbow, the fly fisher’s version of tennis elbow, ice, heat, and Ibuprofen again are your friends. Try changing the size of your grip on the rod handle. When I suffered from caster’s elbow from casting and catching fish all day on the lower Sacramento, the best thing I did was to cushion and expand the grip so that my hand was not clinching down and irritating the elbow tendons. You can experiment and wrap the grip with tennis racket wrap or golf wrap, and there is even a fishing handle wrap on the market. (Editor’s note: see this issue’s Gearhead column.) Or you can use the cushioning material sold for protecting arthritic hands and finger joints.
Finger, Hand, and Wrist Pain. The trinity of ice, heat, and Ibuprofen deals with hand and finger pain, as well. I have been dealing with trigger finger, which is when a finger gets stuck in a down position, and you have to do something to move it back up. If you have it, you can try sleeping with a cock-up wrist splint. Sometimes tape, braces, ice, and Ibuprofen can treat the condition if it has not been going on for too long. I got tired of those aids after several years and finally had surgery to free up the finger tendon. It is a very simple procedure and can be done in the doctor’s office. So far, so good. Carpal tunnel syndrome is tough, and I don’t have any suggestions for that. Arthritis in the fingers is also tough to deal with, but my friend gets relief from Ibuprofen. My physical therapist recommends heat when you get up in the morning, either by running warm water over the fingers or by using a paraffin bath, which can you can buy and use at home. Certain finger stretches keep the joint moving. Again, cushioning your rod grip may help. Using grip-strengthening devices may actually make things worse.
Hip problems. Hip pain can be caused by several conditions — primarily arthritis, tendon strains, tears in the labrum (the cartilage around the hip joint, which afflicted Alex Rodriquez), or referred pain from an issue with your back — you feel pain in the hip area, but it is caused by back problems. You could write a book about all the things that can be done short of surgery, but if the cause is arthritis, you eventually may need hip replacement surgery if you want to stay active. I worked like heck to avoid surgery — pilates, yoga, physical therapy — but at a certain, point, you just get too uncomfortable to put up with it anymore. If you decide on surgery, make sure you consider what is known as the anterior procedure, in which the doctor repairs the joint through a small opening in the top of the thigh. Most surgeons are turning to this procedure because it results in hip stability immediately after surgery and a quick healing time. And the scar is small. I was out fishing three weeks after my surgery, because my doctor said, “You have no limitations.” Don’t do that, but wait four to six weeks before wading much, because you need to strengthen your legs before and after surgery. Your balance will be affected by the surgery, so you need to work on balance, as well, for example, by doing yoga.
Balance. Balance problems could be caused by an inner ear problem, hip surgery, any other lower extremity injury, neuropathy, or simply lack of leg strength in old age. We really have to keep working on leg strength, even more as we get older.
Vision Issues. Eventually, many of us need cataract surgery, but these days, it is a quick procedure with a speedy recovery. Absolutely use polarized lenses not just to see fish, but to protect your lenses and retinas from the sun. Use those little magnifiers you can clip on to the bill of your hat. If you are nearsighted, you can just push up your glasses to tie on a fly or do other close work. A headlamp is good for that, too, even during daylight. And I avoid night driving, because that is another age-related disability.
Despite this dismal recitation of the many maladies that the aging angler faces, there are ways of dealing with all of them that will keep you fishing or get you back out on the water, able to fish once again. Get a reliable diagnosis of any condition, follow your doctor’s advice, do your physical therapy, and then you can share your stories of affliction and recovery with your fellow aging anglers. It adds another dimension to the fishing stories we all tell.