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Battling Boomeritis

by Lindsey Getz

Older adults are staying active longer—and so are their docs.

These days, older adults are pushing themselves further than ever before. While keeping fit is helping keep the boomer population healthy, it’s also leading to injuries. After all, with aging comes a decline in physical capabilities, even for the fittest athletes. That doesn’t mean they can’t stay active—it just means taking precautions and taking action when something is wrong.

There are a number of reasons why people are staying more active. Part of it simply comes down to longevity. “I think medical advances have made it so that people are able to be healthier,” says Craig Kimmel, MD, director of primary care sports medicine at Lourdes Health System. “They’re not becoming disabled at younger ages. I also believe the baby boomer generation was raised in part of that fitness craze and grew up exercising. That has become a positive habit that they’ve continued into later life.”

The baby boomers are definitely leading the way as a group that is showing it’s possible to stay fit later in life. And being told they “can’t do something” is only a motivator in this determined population. “People don’t want to accept disabilities anymore,” says Seth M. Silver, MD, board certified orthopedic surgeon with Reconstructive Orthopedics, with locations throughout South Jersey. “There is no such thing as an old grandmother anymore. Nobody wants a cane and everyone is staying very active. And it’s that kind of lifestyle—regular exercise and a healthier diet—that is also playing a role in keeping people going longer.”

Prone to injury
While staying active is helping people live longer, it is also putting a lot of stress on boomers’ bodies (think joints, muscles, etc.). That extra stress can lead to injury. Laura E. Ross, DO, of Ross Center for Orthopedics with offices in Hainesport and Berlin, says overuse injuries are especially common in this population—especially if not warming up before sports activity. With active older adults, she also sees aggravation of underlying arthritis—especially in the ankles, knees, elbows and shoulders—as well as chronic tendinitis, such as Achilles’ tendinitis and rotator cuff tendinitis. This chronic condition can eventually lead to tendon rupture.

It’s also quite common for the boomer population to begin experiencing problems with back pain. In fact, Larry Deutsch, MD, a board-certified orthopedic surgeon with Coastal Spine, which has a main office in Mount Laurel, says approximately 80 percent of Americans will experience disabling back pain at some point in their lifetime. It’s a very common problem. “As the spine starts to age, you experience something called disc degeneration where the disc collapses,” Dr. Deutsch explains.

“This happens to everyone as they age, but anyone who participates in high-impact activity is going to have it happen faster. I’ve seen marathon runners with advanced degenerative disease who might only be in their 30s but have a back that looks like someone in their 60s.”

Getting early treatment is definitely a key to success with any pain or injury, but unfortunately many people wait longer than they should to seek a doctor’s care. “I think many of us remember the ‘no pain, no gain’ philosophy that we were taught when we were younger, but that’s where people get into trouble,” says Dr. Kimmel.

“Working through a problem isn’t a good idea. It’s always easier to treat a problem early on. If you wait too long, you might not have any conservative options left and could end up needing surgery. It’s important to listen to your body if it’s telling you something isn’t right.”

The “weekend warrior” phenomenon—where the working population only gets out on the court or field come Saturday and Sunday—is also a problem when it comes to injury. “Due to their everyday workday responsibilities, baby boomers are often unable to prepare for sports as they used to,” says Enrique J. Garcia Pena, MD, Orthopedic Surgery and Sports Medicine, Regional Orthopedic Professional Association in Cherry Hill, which works with Kennedy Health System. “As it holds true for so many things in life, preparation is everything. A well-balanced program which includes core strengthening, flexibility and functional training would benefit any individual, regardless of age and level of involvement in any sport—even weekend warriors.”

Varying your activity is definitely important, adds Dr. Kimmel. “I get patients who say ‘I’m a tennis player’ or ‘I’m a runner’ but you can’t do the same thing all the time or you get an overuse injury,” he says. “It’s best for your body to find a variety of activities you can do—biking, swimming, tennis—instead of doing the same thing every day.”

“With a variety of activity, you might not become the best athlete at one particular sport but it’s safer for your body and you’ll be able to stay active much longer,” adds Dr. Deutsch. “Someone who runs all the time is going to wind up with problems with their joints, knees, hips and back. Someone who swims all the time will prevent those disc and joint problems, but their bones could become more osteoporotic as you do need some impact. The answer is variety. I think people have a hard time giving up the idea of being the best at one thing, but in the long run you’ll reap the benefit.”

Advances in treatment
Treatment options are certainly worth exploring as they’ve come such a long way, says Dr. Silver. “We definitely have better options than we used to,” he says. “Nowadays we can do a partial knee replacement instead of a total replacement. And while we used to only be able to inject steroids in the knee, there are now more medicines we can try. We’ve also changed the way we treat people. Incisions are smaller, pain management is better, and overall therapies are more aggressive and geared for the young minded who want to get back out there. We’ve moved in the direction of same-day surgery.”

“There are definitely more and better treatment options available to help people get back to their sport sooner,” adds Dr. Ross. “There are more efficient ways of surgically treating orthopedic conditions than ever before, including minimally invasive techniques like quad-sparing knee replacements and arthroscopic rotator cuff repairs. These techniques, along with advances in rehabilitation medicine, are enabling boomers to get back out on the golf courses and tennis courts.”

When it comes to back and neck problems, Dr. Deutsch says treatment has also gotten much more conservative. Most of the time patients respond to physical therapy, medication and exercise, without having to go the route of surgery. “Sometimes we’ll do spinal injections,” he adds. “But even surgery has become markedly more conservative. Everything used to be done through big incisions and with long hospital stays. Now we’re doing things with tiny incisions, with much less blood loss, and much less time spent in the hospital.”

Stay active, stay healthy
Although activity has the potential to lead to injury, staying active is the best advice doctors can give. Dr. Pena says just 30-60 minutes a day of physical activity will prepare you for weekend endeavors out on the court or in the field. Just don’t forget to also take the time to rest between activities. “Rest and recovery is a very underrated aspect of fitness that is often taken for granted by this population of sports enthusiasts,” he says. “As we age, our flexibility, our joint and muscle elasticity, and our ability to recover are all compromised.”

That’s also why warming up is so important. As people age, they often maintain strength but lose flexibility, so it’s important to stretch out those muscles. “And don’t forget the upper body,” adds Dr. Silver. “Everyone seems to remember to stretch out their lower extremities but forgets about the upper half of their body.”

And if you do have an injury, take time to let it heal. “As soon as people start to feel better again, they get back out there, but the ligaments and muscles might not be up to par yet,” says Dr. Deutsch. “A lot of people will re-injure themselves because they got out there too soon. Remember that an injury needs the proper time to heal or it could become a chronic problem and that’s harder to fix. Some common sense and care goes a long way to long-term good health.”

Published (and copyrighted) in South Jersey Magazine, Volume 11, Issue 3 June, 2014).
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