Boomers With Bad Knees Need to Slow Down

Medically Reviewed by Charlotte E. Grayson Mathis, MD
From the WebMD Archives

Feb. 15, 2002 -- The nation's largest group of orthopaedic surgeons has some bad news for the legions of fitness-conscious baby boomers literally trying to outrun middle age. Those with knee problems may need to hang up their jogging shoes and find more age-appropriate forms of exercise.

Giving up body-punishing sports like running and weekend basketball is better than surgery for boomers with knee problems caused by arthritis, the experts say. That is because active people in their 40s and 50s are not ideal candidates for surgical treatment.

"Middle-aged patients who've had knee surgery recommended to them should try less aggressive alternatives first," says orthopaedic surgeon Arlen D. Hanssen, MD, of the Mayo Clinic. Hanssen moderated a symposium on knee surgeries in baby boomers Thursday at the 69th annual meeting of the American Academy of Orthopaedic Surgeons, held in Dallas.

He says patients in their 40s and 50s are often no longer flexible enough to benefit from ligament reconstruction surgeries that routinely restore athletic function in younger patients. Likewise, highly active patients who are middle-aged make poor candidates for knee replacement surgeries because such surgeries require a decrease in physical activity.

"A middle-aged person who loves singles tennis potentially risks repeat surgeries by putting their artificial knee through premature wear and tear," Hanssen says.

The best treatment course, therefore, is to delay surgery for as long as possible by switching from high-impact sports to those that are easier on the joints, like biking, swimming or walking, Hanssen says.

Orthopaedic surgeon and baby boomer Nicholas DiNubile, 49, agrees. But he says it is a message that most middle-aged fitness fanatics won't want to hear.

"Boomers have no intention of aging gracefully," he tells WebMD. "They are not going to go down without a fight. We are the first generation in history that expects to be fit and as active as we want to be into our old age."

A sports injury specialist who consults for the Philadelphia 76ers and the Pennsylvania Ballet, DiNubile says he came up with the term "boomeritis" to describe the growing number of sports injuries he was seeing among middle-aged patients. He confirmed his observation with data showing a record number of hospital visits in the late 1990s by people born between 1946 and 1964 due to sports-related causes.

He says patients with boomeritis tend to have unrealistic expectations about what can be accomplished with surgery. And those who continue to punish their joints by engaging in high-impact sports and exercises following surgery can expect to have more problems.

"High impact sports don't cause arthritis, but they do accelerate it," he says. "If there is damage, they will certainly cause a knee to wear out quicker."

Cross-training is vital to avoiding injury, he says. Focusing on a single activity may be fine for younger athletes, but it is a game plan for trouble as you age. Achieving a balance between cardiovascular activity, strength training, and flexibility exercises is key. And keeping your weight under control is also important to reducing stress on joints. Even a modest amount of weight loss can have a dramatic impact on knees.