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As life expectancy increases, record numbers of people are remaining active well into their later years. Counseling these individuals with regard to the prevention of sport-related musculoskeletal injuries and treating injuries when they do occur demands an understanding of age-related changes within the musculoskeletal system. It is now known that a significant component of what was once believed to be age-related muscle deterioration is the result of disuse atrophy. Review of track and field records of well conditioned masters athletes indicate that only a gradual decline in peak performance takes place through the first six decades of life. Deterioration in peak athletic performance is more rapid in events that require speed and power than in those that stress endurance. These observations are supported by clinical and laboratory investigations that suggest a preferential loss of fast twitch muscle fibers with age. Overuse injury to muscle represents the most common injury seen in all athletes. Muscle is especially susceptible to injury during eccentric contraction. While it is controversial whether an increase in the risk of injury is seen with aging, it does appear that older athletes recover more slowly after injury. This makes injury prevention in this population especially important. Good results can be expected with the use of an exercise regimen that stresses flexibility and gradually progressive strength training.