Monday, October 13, 2008

Health

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Injury-Free Workouts

Getting creakier? You may want to ease up with age, but you don't have to stop

By Katherine Hobson
Posted 6/17/07

Andrea Evian does not do things half-heartedly. As a child, she grew up playing all kinds of sports, and her exercise habit was set for life. Now 55, she skis every weekend during the winter, plays tennis a couple of times a week, and hits the gym six days out of seven for spinning classes, kickboxing, or weightlifting. All that activity has landed her in the orthopedist's waiting room more than once: She's had a ligament in her knee and one rotator cuff repaired and has arthritis in her feet. Her orthopedic surgeon jokes she should get frequent-flier miles for her visits. She's slowed down some-cutting back a bit on tennis, avoiding the high-impact aerobics classes she used to take-but by no means is she stopping. "I don't give up too easily," she says.

That may as well be the motto of her entire generation, already famous (or infamous) for the stamp they've left on every life stage through which they've passed. A constant has been fitness: This is the group that jogged along with Jim Fixx, got physical to the strains of Olivia Newton-John, and led the walking boom. Now they're in their 40s, 50s, and 60s, and if you think they're going to gracefully accept the limitations of old age-well, that just isn't going to happen. Nor, really, do they have to: Advances in orthopedics and sports medicine mean that the injuries that used to sideline anyone with a hint of gray hair can now be fixed. With an eye to prevention, boomers can stay on the playing field for years. And those who missed the first several exercise revolutions have no excuse not to start now. Humans weren't designed to be sedentary, experts note.

But were they designed to play three hard sets of tennis, five days a week, well into their 60s? Maybe not. The unprecedented increase in life expectancy (from 47 years for a child born in 1900 to nearly 78 for a child born in 2004) in the past century means "we've got a mismatch between longevity and durability," says Nicholas DiNubile, an orthopedic surgeon who practices in Havertown, Pa., and is the author of Framework, a guide to developing a sustainable routine. That can lead to what he calls "boomeritis": the panoply of injuries ("tendinitis, bursitis, arthritis, and fix-me-itis") that accumulates after middle age.

A paper on the aging athlete published in October 2005 in the Journal of the American Academy of Orthopaedic Surgeons lists the effects of aging on the musculoskeletal system. Among them: Bones lose density and strength; ligaments and tendons stiffen, lose circulation, and become more vulnerable to injury; cartilage becomes stressed and susceptible to tearing; and muscle mass decreases. Many of these effects can be improved by exercise, but they also make people more vulnerable to injury: Sports injuries are second only to the common cold as a reason to go to the doctor, according to a report published in 2003.

When prevention fails, medicine is increasingly able to keep injuries from ending an athlete's run. "When I was in training 25 or 30 years ago, if you were over 40 and had an anterior cruciate ligament tear, you got a brace and you lived with it," says DiNubile. "Surgery was a major intervention; the results weren't that great, and recovery took six months or a year." No longer. Thanks to new technology, ACL reconstructions can be done with a 1-inch incision, and age is no longer a limiting factor. "If you'd have told me years ago I'd be operating on a 60-year-old, I wouldn't have believed you," he says.

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