Susan J. Long lives life in forward motion.
The Pasadena resident played competitive tennis in high school and college, and early in her marriage to Tom Long, both ran. When tennis beat up their joints too much, the couple started cycling in 2006, eventually riding up to 60 miles a day, and touring the U.S. and Europe. But by then, Long’s athleticism had taken its toll.
Enter pain. Long, now 68, first noticed it in her left knee in 2011. Arthritis. She tried injections, topical ointments, physical therapy and over-the-counter NSAIDs (nonsteroidal anti-inflammatory drugs) for two years. Eventually, the pain exceeded her tolerance threshold. It would take a full two minutes for the wincing and hurt to subside when she stood up from sitting. Unable to cycle, Susan handed her bike to Tom, exasperated. “I am done,” she said.
In October 2013, she had complete knee replacement surgery. That was on top of another procedure she’d had 10 months earlier — a complete reverse reconstruction of her shoulder, replacing both the ball and socket with metal parts. The cause was a fall she’d sustained when she reacted too slowly to cyclists stopping suddenly in front of her. Her surgeon said existing osteoporosis had caused her shoulder to shatter so severely.
“So here I am, years later, cycling,” said Long, speaking by phone from New Zealand, where her cycling group was touring the island, pedaling up 2,000-foot-high hills and up to 50 miles a day. “Today we went deep into a cave where the glowworms are and then rafted down the river. I was thinking all along that I would never have been able to do any part of that tour if I hadn’t gotten a new knee.”
Aging baby boomers — the 76.4 million Americans born from 1946 to 1964 — are finding that habitually active lives have a flipside: painful arthritis and worn-out, achy joints. With many boomers ignoring their age as they engage in physical activities, some are outliving their joints. Dr. Nicholas DiNubile, an orthopedic surgeon at the Hospital of the University of Pennsylvania, coined the term “boomeritis” to describe arthritis, tendonitis and bursitis afflicting aggressively physical boomers.
Indeed, arthritis is the leading cause of pain and disability globally, according to the Mayo Clinic. Recent studies suggest that by 2030, when the last of the baby boomers turns 65, the number of people 65 and older with arthritis and chronic joint symptoms will double. From 2010 to 2012, an estimated 52.5 million U.S. adults (22.7 percent) were diagnosed with arthritis (joint inflammation) and osteoarthritis (degenerative cartilage disease of the joints), according to the Centers for Disease Control and Prevention.
Boomers are faring worse than their parents for a couple of reasons: One, they are in the first generation to make vigorous exercise an important part of their lives, and any high-impact movements make their joints especially susceptible to arthritis. And previous injuries, such as torn ligaments, fractures or sprains, in their younger years can also lead to arthritis.
But fitness obsession isn’t the only cause of boomers’ joint ailments. Paradoxically, another problem is their weight: boomers have higher rates of obesity and arthritis than their parents, “the silent generation” (born 1925–42), and they were heavier at a younger age than their predecessors, a 2005 American Journal of Public Health study found. The study suggests that obesity contributes to more cases of arthritis in boomers, and the overweight 65-and-older set are at greater risk for arthritis. Some 23 percent of overweight older adults and 31 percent of the obese ones were diagnosed with arthritis, according to the study.
“Baby boomers are one of the biggest generations in total numbers, and they are staying physically active while they age, and they expect to stay active while they age,” said Dr. Thomas Muzzonigro, a Pennsylvania orthopedic surgeon who chairs the American Academy of Orthopedic Surgeons’ communications committee. “Older generations gave up physical activity as they aged. I never saw my grandparents do any active sports. They were old at 50.”
At 50, Dr. Muzzonigro is nothing of the sort, but the former rugby player is also an example of the boomeritis epidemic. He still works out and plays football and basketball, but his arthritic back prompted him to add yoga with his daughter. Though many boomers are still active and fit, he says that he has conversations with people all day “where I say, ‘You know you have two bad knees, but I cannot do surgery safely unless you lose weight.’ Then they say, ‘How can I lose weight when I have two bad knees?’”
For Brandon Flowers, 53, fitness is not just a lifestyle but also a calling. As owner of Dynamix Strength Advantage in Eagle Rock for the past 24 years, he lives what he preaches. Flowers uses weights, rubber-tubing resistance training, balance boards, stability balls and discs in his training sessions. He offers them twice weekly for employees at Pasadena’s Jet Propulsion Lab, and for cancer survivors at The Wellness Community in Pasadena. But after a life of playing football, running and working out, Flowers’ knee was shot despite employing all his own strengthening tactics. “I had severe tri-compartmental degenerative arthritis,” he said, adding that he was three weeks post-surgery and rehabbing with ice and elevation. “The technical term for what the MRI showed was the tibia and thigh bone were kissing each other.”
A self-described “big guy,” Flowers had knee surgery in high school to repair torn ligaments. His knee became arthritic and by the time he was 50, an orthopedic doctor said he would need a new joint. Three weeks into recovery, he is stir crazy but energized by the prospect of returning to an active life, pain-free. “The knee got to a point where I just could not keep going,” he said. “I was living with ice packs and anti-inflammatory [drugs] and physical therapy.”
Around 7 million Americans are living with a hip or knee replacement and, in most cases, are mobile, according to the Journal of Bone and Joint Surgery 2015 study. About 1 million replacement surgeries are done annually. By 2030, when the youngest boomers turn 65 and the oldest boomers are 84, annual demand for total hip replacement is estimated to almost triple, from 209,000 to 572,000. Total knee replacement is estimated to increase more than seven times over the same period, from 450,000 to 3.48 million a year.
Recovery from knee or hip replacement surgery is arduous, but Flowers is sure he will get back to his “normal” active self. The doctor said he could expect to be 80 percent back to normal in 10 to 12 weeks. As for Long, she said that with each surgery (she also broke her neck in a car accident), she feared she would never reclaim her former life as an active and vibrant woman. “Much to my surprise, in each case, I did recover,” she said. “With my broken shoulder I thought I would never be able to lift even a coffee cup and with my knee, I thought I would never be able to push one pedal stroke on a bike. The body is an amazing thing. It does heal, along with the heart and soul.”
Julena Lind, 69, a retired university administrator, is six months into her recovery from a hip replacement surgery. A life of running, jumping, skiing, skating, high-impact aerobics and squatting, plus genetics (her mother had arthritis and hip replacements) had resulted in arthritic hip pain which first appeared in occasional twinges at age 60. But the pain did not impinge on her ability to exercise as intensely as she liked for some time. It would be eight years later, when the pain grew so severe that Lind stopped high-impact workouts but continued doing low-impact training sessions.
“There was no way I could run, do jumping jacks or squats anymore,” said Lind, who sat gingerly, nursing a cup of Earl Grey tea, at Starbucks. “My ortho said you need a hip placement, you have no more cartilage. It is bone on bone.” Whippet-thin and a longtime exercise addict, Lind says she decided at that appointment not to have the surgery yet. She wanted to wait until it ‘‘hurt a lot.’’
That didn’t take long. “Ten months later, it hurt a lot,” said the Santa Monica resident, and her doctor again recommended surgery. “I was able to accept it,” she said. “The ortho said you are going to do fine. You are fit.” On the third day post-surgery, Lind walked for 2½ hours along the Venice Boardwalk. On the fifth day, she returned to the gym doing three to four low-impact aerobic classes a week. But, no more jumping or low squats. Ever.
Some boomers try musculoskeletal strengthening and fitness training rather than surgery. One of them is Patti Sheaff, 61, who has been surfing for 48 years. She started skydiving at 28 and snowboarding in her early 40s, which took her all over the U.S. and Canada. With all that snowboarding, her sacrum (lower spine) took a thorough beating, fracturing several times. After a bad fall in 2010, the Santa Monica adventurer had to hang up her snowboarding boots. A bone density test revealed she had arthritis, scoliosis and osteoarthritis. Yearly bone density tests, she says, show continuing bone loss.
To abate it, Line drinks bone broth and takes supplements with bisphosphonates, calcium and magnesium. For two years, she stopped taking any pain medication and has been doing isometric poses combined with disciplined breathing exercises to strengthen her body’s musculoskeletal structure. She has been able to surf, paddleboard and body surf pain-free. “The idea [of isometric exercises] is for the muscular structure to absorb the impact of pounding rather than your skeleton,” she said, adding that she is studying a strengthening method to reduce pain, touted by buff actor Chris Hemsworth, called Foundation Training; it was created by a North Carolina–based chiropractor named Eric Goodman (foundationtraining.com).
Joint replacement surgery is major surgery and the remedy of last resort. Rehabilitation and physical therapy is typically prescribed for three months or more. It can be challenging and painful. But many boomers who opt for surgery to stay active say it is worth it. Today’s state-of-the-art materials and methods are far better than even what was available in 2000, Muzzinigro said. Replacements simply last longer, so that if a person in his/her 50s or 60s undergoes joint replacement today, it will likely last a lifetime.
Even though boomers typically pursue a physically active life, most understand that at some point, they may have to alter their attack-it attitude. As for the Longs, who have found their post-tennis passion in travel cycling with a tight group of friends, they know at some point they may need an assist. “Electric bikes are coming into fashion,” said Susan Long, referring to what is known as “pedal-assist electric bikes.” “And we often say now that when we get into our 80s, perhaps we’ll want to get that extra boost!