Canadian health officials recommend adults 65 and older accumulate at least 150 minutes of moderate to vigorous aerobic activity per week.Keith Meyers/The New York Times
"It was probably 2 or 3 in the morning. I thought I heard something downstairs. I rushed into the kitchen and inadvertently stepped directly into the dog's water dish, slipped forward and pulled my hamstring. In two weeks, in celebration of my 65th birthday I'm scheduled to run the New York City Marathon. Doc, will I be good to go?"
John is a patient of mine and has been for some time. He's called on me to fix the odd sports injury over the years but, for the most part, he lives his life ahead of the curve. As such, our work together has been mostly preventive in nature. Committed to living an active lifestyle, he bikes, walks and participates in weekly pilates, yoga and spin classes. Six months ago, he started training for his first marathon to mark his 65th birthday. Ironically, it was his dog's water dish that brought him to a standstill, not arthritis or an aging body.
Such optimistic fitness goals were unheard of a generation ago, when few people in their 60s would expect so much from their aging bodies. Gone is the acceptance that a decline in physical health and diminished performance is an inevitable part of aging. John's expectation of his physical capabilities, for a man in his mid-60s, is not uncommon today: 65 is the new 40.
Baby boomers are pushing the orthopedic limits of their bodies. They are training harder, looking for new physical challenges and surrounding themselves with professionals to help them accomplish their goals. Pushing the limits of an aging body comes with some risk. This new reality has given way to a medical trend that orthopedic surgeons, chiropractors and physiotherapists are calling "boomeritis." The term, coined by American orthopedic surgeon Dr. Nicholas DiNubile, refers to injuries sustained among ambitious older adults who participate in competitive sports, adventure travel and other physically demanding activities.
Baby boomers are now somewhere between 50 and 68 years old. By 2031, all baby boomers will have reached 65, and the proportion of seniors in Canada will likely reach 23 per cent, compared with 15 per cent in 2011. As we get older, various soft tissues (bone, tendon, muscle, spinal discs) go through predictable wear and degeneration. Cartilage, the smooth, shiny surface that cushions our joints, softens and can wear thin with age. Muscle mass peaks at age 25 to 30, and then decreases by about 4 per cent a decade until the age of 50, when it drops by about 10 per cent every 10 years.
Many of these changes occur under the radar, without any symptoms. Add to this old injuries, a sedentary lifestyle, a "no pain, no gain" mindset in preparation for an exciting, upcoming adventure and you have the perfect storm to create an untimely, age-related injury.
The good news is that "boomeritis" is preventable.
I treat high-performance baby boomers who ski, box, golf, curl, wakeboard, run, garden, play soccer, hockey and baseball. Those, like John, who have done so without injury or in spite of arthritic joint pain typically attribute their success to hard work and a dedicated strategic approach to healthy aging – not to superior DNA. The idea that we are handed a genetic destiny at birth, set in stone regardless of lifestyle practices, is old thinking. I must hear a dozen or so patients a day ask me how their pain is related to aging. "Well doc, the knee flared up again this weekend after playing tennis. I guess I'm just getting older. Maybe I should be giving up the game." Not so fast.
In simplified terms, health is defined by four factors: age, current level of physical fitness, nutritional health and genetics. A well-designed, co-ordinated strategy that addresses each factor reduces the risk of age-related decline and supports the body's ability to adapt and get stronger. Note, two of the factors are under our direct control – nutrition and fitness. If it's tennis that you love, explore how your approach to the sport and your preparation to play it need to change to keep you on the court. Here are the key factors to consider as part of this process:
Listen to your body.
Pain is an excellent motivator, but waiting for it to show up before you seek help can complicate a recovery. Before pain prevents activity, address restricted range of motion, difficulty with balance or regular movement patterns and/or diminishing flexibility. In other words, if you suddenly can't turn your neck all the way, hold a familiar yoga pose or bend the way you used to, reach out to a clinician who will help you monitor your musculoskeletal health.
The body is made for motion.
Improving flexibility and range of motion takes practice and must be worked on every day. Gains here will help avoid soft-tissue microtrauma that is the hallmark of "boomeritis" and enhance balance, preventing falls. Walking, swimming, aqua-fit classes, tai chi, dancing, biking and cross-country skiing are all good options. Start moving but start slowly. To achieve health benefits and improve functional abilities, the Canadian Physical Activity Guidelines recommend adults 65 and older accumulate at least 150 minutes of moderate to vigorous aerobic activity a week, in bouts of 10 minutes or more.
Lean muscle mass works for you.
Strength training rebuilds atrophied muscles and strengthens bone. It is a must. Lean muscle also burns more calories, helping you maintain a healthy weight. A gym membership is not required. A simple set of resistance exercise bands and a home program designed by a qualified health professional will do the trick. Major muscle groups should be targeted twice a week.
Good exercise doesn't have to be high impact.
Replacing or reducing high-impact activities (e.g., running and jumping) with more joint-friendly sports (e.g., biking and swimming) will help improve your capacity and enjoyment for movement.
In the end, there is no silver bullet. The right strategy and some discipline are the keys to pushing the boundaries of healthy aging and performance. As for John, he will be good to go. His dog, however, will no longer be drinking water from the kitchen.