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Weak In the Knees: Baby Boomers Need Lifestyle Changes, Not Surgery

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arthritis, osteoarthritis

Weak In the Knees: Baby Boomers Need Lifestyle Changes, Not Surgery

March 18, 2002
By Bianca Gwinn, Knee1.com Approximately 78 million baby boomers (Americans born between 1946 to 1964) grace the sidewalks each day. As America ages and medical advancements allow us to live longer, boomers will become a much larger factor in the American healthcare delivery system. The road to middle age, however, is not paved as smoothly as one might hope. As baby boomers age, changes in health status become more apparent with aches and pains, increased visits to the doctor, and more prescribed medications or surgical procedures. "Surrounded by fitness and athletic industries," says 43-year-old Kathleen Brown, "I pushed myself to stay in shape and became the victim of an invincibility syndrome, believing that I could do what I did at 25 instead of changing my daily regimes to accommodate my aging body. After continuing with my high impact aerobics and running, my knees started to wear out." Brown now suffers from arthritis in her knees – a condition that has become a major culprit for baby boomers’ added trips to the doctor’s office. Currently, 23 million Americans suffer from osteoarthritis. That's one in every eight adults! As baby boomers enter the osteoarthritis-prone years, the number of sufferers is projected to increase substantially. Physicians say that aside from heart disease, arthritis is the most debilitating condition for adults, robbing them of their ability to walk, climb stairs and even stand up. This health problem has become a hot topic of health discourse and preventive policy. Until recently, researchers thought that osteoarthritis was simply a matter of wear and tear; a grinding down of the slick, elastic cartilage that cushions and lubricates the ends of all bones. Mechanical forces certainly play a role, especially in initiating joint damage. Earlier injury to the knee, whether from athletics, repetitive overuse or exhaustion, increases one’s risk for later knee arthritis by three to six times. However, further studies reveal that mechanical forces do not totally explain arthritis. Overweight individuals are at greater risk (four to five times) of developing knee arthritis. With each step, weight-bearing joints must bear a force equivalent to up to six times one’s total body weight. Thus, it makes sense that there's a strong link between osteoarthritis and weight. Biochemical factors also play a role in influencing one’s risk for knee arthritis, as does heredity, hormones and diet. While the dominant treatment approach continues to be corrective knee surgery, orthopedic surgeons are becoming more and more likely to suggest alternative solutions. And the methods for treating the symptoms of arthritis have increased dramatically in the last decade. "Fortunately, there's a lot of progress in arthritis medicine, " says rheumatologist David T. Felson of Boston University School of Medicine. "The emerging paradigm is that this is a disease that needs to be treated with multiple approaches." At a recent meeting of the American Academy of Orthopedic Surgeons, Dr. Arlen Hanssen promoted safer alternatives for baby boomers whose knees are giving way to arthritis. "They come in and say, ‘Fix me,’ and they hope for complete cessation of symptoms without any change in their activities. However, what [baby boomers] don’t realize is that this continual aggressive activity will only exacerbate their [knee] problems," says Hanssen, an orthopedic surgeon at the Mayo Clinic. He believes this middle-aged population needs to delay surgery as long as possible and should pursue more conservative (and non-operative) lifestyle changes that will bring ease to the knees. These less-aggressive alternatives include low-impact exercises like swimming, bicycling, walking and golf that place less pressure on the joints. Effective medication, bracing and physical therapy are also suggested in many cases to help treat arthritis. A consistent balance between strengthening the leg muscles and maintaining flexibility helps alleviate pain from knee arthritis. Strong leg muscles brace the knee and hip joints, reducing the wobble that comes with the loosening of ligaments as we age. Increased joint stability in turn protects cartilage from detrimental cycles of injury, enzymatic breakdown and inflammation that causes arthritis pain. Many of these gentle, progressive resistance exercises can be done at home using small ankle weights or elastic bands. A recent Tufts University study revealed that a home exercise regimen improved leg strength by 71% and reduced arthritic knee pain by 36%. The new strategy for baby boomer arthritis care represents a more proactive and preventive approach rather than an aggressive reactionary approach to treatment. Dr. Hanssen adds, "The tendency to stay on the go longer has raised the demand for surgery. However, surgical options need to be the last resort for an arthritic patient because they are very intrusive and medically complex. Orthopedic surgeons must exercise great care in selecting patients from the middle-aged population for this and other knee surgeries." As America faces the challenges of an aging population, the search for a cure for arthritis becomes more important. Until that cure is found, increased knowledge about arthritis and effective lifestyle changes are crucial keys to helping baby boomers learn to live with this chronic and sometimes debilitating disease.

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