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Boomeritis: "Extending the Warranty" on Aging Baby Boomer Bodies

Nicholas DiNubile, M.D.,
orthopedic surgeon at DCMH,
discusses the effects of aging
on the musculoskeletal
system and ways baby
boomers can prevent these
problems.

Do your knees crack and pop when you walk?  Is your back stiff when you get up in the morning?  Does your shoulder hurt when you swing a golf club or tennis racquet?  If you suffer from these or similar aches and pains and you’re between age 40 and 60, you may be afflicted with "boomeritis". Nicholas DiNubile, M.D., an orthopedic surgeon at Delaware County Memorial Hospital, coined the term to describe the onset of tendonitis, arthritis, bursitis and other musculoskeletal conditions in baby boomers, combined with their determination to remain physically active far later in life than previous generations. Dr. DiNubile recently offered a seven-step program for “extending the warranty” on your aging muscles, bones and joints by improving your overall physical condition.

Preventing Musculoskeletal Problems

1. What can baby boomers do to prevent musculoskeletal problems from occurring in the first place?

Listen to the answer

2. Dr. DiNubile, what is your advice for people who are suffering from musculoskeletal problems?

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Read the Article

Baby boomers have no time for pain or inactivity. Determined to stay physically active as they get older, they seek an instant fix for arthritis, tendonitis, bursitis and similar conditions that accompany the aging process. In fact, musculoskeletal problems top the list of reasons why people, and especially baby boomers, are visiting the doctor today. One in seven Americans is affected by such ailments. Why has this emerged as such a problem? For baby boomers, it’s a matter of living longer and trying to stay active – sometimes too active – on an aging body frame.

Baby boomers are facing a stark truth: while the average life expectancy has increased from 46 years a century ago to 75 or even 80 years today, the durability of the musculoskeletal system has not kept up. “Through medical advances, we have added more years to the human life span during the last century than in all the previous years in the history of mankind combined,” says Nicholas DiNubile, M.D. an orthopedic surgeon at Delaware County Memorial Hospital. “In the process, we’ve created a mismatch: longevity versus durability. We have outlived the warranty on our musculoskeletal frame.”

According to Dr. DiNubile, baby boomers want to remain active but they are not willing to live with symptoms. “In previous generations, people stopped the activity that triggered the problem or they put up with the pain. But baby boomers want it fixed. I call it ‘fix-me-itis’ or boomeritis.”

The best “fix,” he insists, is to prevent your body from breaking in the first place. In his recently published book, Framework, Dr. DiNubile offers a seven-step program to promote lifelong optimal health, both musculoskeletal and general, by improving your physical condition.

Step 1: Evaluate Your Condition

Begin by assessing your physical condition and identifying your areas of vulnerability. Consider all aspects, including your inherent strengths and weaknesses, exercise and diet regimen and any genetic factors. A free self test is offered at Dr. DiNubile’s web site, www.drnick.com. “We all have vulnerable areas,” he says. “You may have an old injury or ailment where your rehabilitation was incomplete. You might have an imbalanced exercise routine that is strengthening some parts of your body but creating problems with other parts. Or you may have inherited orthopedic conditions such as arthritis or poor spinal alignment.” Dr. DiNubile emphasizes that while not every weak area can be fixed, you can learn to safely work around them.

First, it’s important to understand how the body ages. Just as your hair turns grey and your skin begins to wrinkle, your musculoskeletal tissue goes through biochemical changes that increase your vulnerability. As a result, the probability of injury increases along with the severity of injuries. Healing time increases while the degree of healing decreases. You probably won’t bounce back 100 percent from an injury the way you did when you were younger.

When it comes to aging, all body parts are not created equal, according to Dr. DiNubile, who is a physician for the Philadelphia 76ers and the Pennsylvania Ballet. The human body has over 200 joints, but only a few of them typically wear out, such as the knee and the hip. “They are not built to last as long as people are living today, especially when they are regularly used for strenuous physical activity,” he says.

Peak bone mass occurs in your twenties. After age 40, you are constantly losing bone mass and once you lose it, is very hard to get it back. Weight-bearing exercise helps because bone responds to stress and strain by creating more bone.

Muscle peaks at age 25 or 30. After age 40, you lose one percent per year until age 50. After that, you lose it even faster. However, muscle is easier to build back than bone with the appropriate exercise program, so at any age, you can reverse muscle loss.

Tendons weaken with age by losing elasticity. Picture the elasticity in a fresh new rubber band. Now compare that to an old one that is dried up and brittle. This is what happens to your tendons, usually due to repetitive use and/or decreased blood flow to the tendons. As tendons weaken, they can become inflamed which results in tendonitis. With proper exercise, you can improve blood flow and regain elasticity in your tendons, but if you do the wrong kind of exercise or overuse an inflamed tendon, it may eventually tear. This often happens in joints that are overused such as the rotator cuff in the shoulder joint.

As your spine ages, the disks between each vertebrae lose water content. A normal disk is similar to a grape. As it loses water, it becomes degenerated and looks more like a raisin. At this point the disk is more susceptible to herniation, a painful condition that often requires surgery.

“Despite the aging process, your body is constantly trying to repair itself. You can help through proper exercise, nutrition and stress management,” says Dr. DiNubile.

Step 2: Cardiovascular Exercise

Cardiovascular exercise three times a week will help extend the warranty of your musculoskeletal system by improving blood circulation throughout your body. This is important for microcirculation – the network of small vessels in your body that nourishes the muscle tendon areas. Your exercise program should be customized to suit your personal condition. People with back problems, for example, shouldn’t use rowing machines. If you have an arthritic knee, walk or swim instead of running. If you have a stiff neck or bad shoulder, swimming may not be the best activity for you. “No matter what activity you choose, it’s important to warm up to the point where you break a sweat,” Dr. DiNubile advises. “This increases the elasticity of your muscle tissues and tendons which, in turn, reduces the risk of injury.”

Step 3: Strengthening Your Core

Your body’s core includes the abdominal muscles, lower back muscles and pelvic area. A strong core helps to prevent back problems and knee injuries and improve performance. The best way to strengthen this area is by exercising with a large stability ball or Swiss ball or by taking a class in Pilates, marshal arts, Tae Chi or yoga.

Step 4: Powerful, Pliable Limbs

Strength training two or three times a week helps to develop powerful, pliable limbs. Weight lifting in moderation is important for men and women. Yoga is a great way to improve flexibility. When planning your exercise, be sure to work around any problems you have such as a bad back or an arthritic knee. “Motion is lotion for your joints, as long as it’s the right kind and the right amount. Don’t overdo it,” warns Dr. DiNubile.

“Sedentary behavior is not an option for any one,” he adds. “It’s as dangerous to your health as smoking a pack of cigarettes a day.”

Step 5: Rest and Recovery

Your body needs a period of rest and recovery between exercising. “Very few exercise routines should be done every day, with the exception of walking and stretching,” says Dr. DiNubile. “More strenuous exercise such as running will lead to injuries if done every day. Cross-training is good because one part of your body has time to rest while another is working. And deep, restorative sleep is very important to your body’s ability to repair and regenerate itself. If you have a sleep disturbance such as snoring or sleep apnea, it’s important to address it.”

Step 6: Nutrition

Good nutrition is as essential to the health of your musculoskeletal system as it is to your heart. Eating foods that are low or free of sugars, saturated fats and transfats is key. Friendly fats such as omega 3 fats found in fish and eggs are good for your joints. High quality carbohydrates provide the energy needed for physical activity. Calcium and vitamin D are essential for bone mass and strength. Limit your intake of soft drinks because they contain phosphorous which blocks calcium absorption.

Weight control is also essential. “For every pound you carry, your knee thinks you are carrying five to six pounds,” says Dr. DiNubile. “So losing seven or eight pounds reduces the weight load on your knee by 40 to 50 pounds, and studies have shown that to be enough to slow down the progression of knee osteoarthritis.”

A word about smoking. Smoking is as bad for your muscles, bones and joints as it is for the rest of your body. Smokers have a higher incidence of low back pain, degenerative disk disease and rotator cuff tears than non-smokers. When a smoker breaks a bone, it doesn’t heal as quickly or as well. That’s because smoking affects the microcirculation that keeps blood flowing to your musculoskeletal tissues.

Step 7: The Mind/Body Connection

Stress control and a positive attitude can help to improve the condition of your frame. The negative effects of stress may include neck pain and back pain among many other problems. Exercise is one of the best stress busters. Programs such as Tai Chi that include meditation are very effective at stress reduction.

Advances in Treatment

For those baby boomers who suffer despite their efforts to stay in shape, the future has never been more promising. “This is the bone and joint decade in research,” notes Dr. DiNubile. Some of the newest developments in treatment include partial joint replacements and an injectable lubricant for knee joints that is longer acting than cortisone and safer for your joints. Recently, a new female gender specific knee replacement was introduced featuring a slender shape that provides women with better mobility and flexibility. Still in the experimental stage are biological knee replacements in which some of the patient’s own tissue is used to regrow tissue in the injured part of the knee.

Prevention is the best approach of all, Dr. DiNubile emphasizes. “Baby boomers can get more mileage out of their muscles and joints by making sensible exercise and nutrition part of their daily lives.”

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