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Baby boomers: The next arthritis generation

By John Esdaile, Special to the Sun September 28, 2011

Seven years ago Dr. Jim McLennan was pulled out of retirement to help at a local medical clinic in Burnaby and he’s still at it. Despite being active, arthritis affects most elderly people. Photograph by: Glenn Baglo, PNG

As co-leaders of the National Arthritis Awareness Program, Vancouver-based Arthritis Consumer Experts (ACE) and the Arthritis Research Centre (ARC) have met primary care physicians, pharmacists and media educators who are seeing a growing number of aging baby-boom Canadians who are coming to their clinics with questions about arthritis.

Indeed, baby boomers everywhere are just starting to approach what they thought they never would: old age.

An increasing number of people born between 1946 and 1965 will be eligible for senior citizen discounts at restaurants and movies and on public transit.

And many have sore, creaky joints, the ultimate badge of aging. They also account for 80 per cent of health care product purchasing. This demographic is also not fond of old stereotypes associated with aging.

In British Columbia, baby boomers account for nearly one-third of our population. If this large group intends to keep up their healthy lifestyles and youthful attitudes, then they need to immediately take steps toward early diagnosis and prevention of arthritis.

At the primary care conference, we met Leonard Wolf, a family physician from Kamloops, who at 49 is at the younger end of the baby boom spectrum. When playing with his dogs or his two school-aged boys, he seemed younger still. But even at his age, he was no stranger to the pain of arthritis; he has severe bursitis in each elbow. And thanks to an incredible list of rugby and skiing injuries from his high school and university days, it may only be a matter of time before osteoarthritis creeps into his knees. “I am very concerned I won’t be able to do the things I want when I retire,” Wolf said.

Scientific experts at ARC say he is justified in his concern, since knee injuries are the most common type incurred in sport and a single knee trauma sustained before age 18 triples the chance of getting osteoarthritis later in life.

People in Wolf’s generation are putting a new face on arthritis. According to a report from the Public Health Agency of Canada, aging baby boomers are at the centre of a growing epidemic. Today, more than 4.2 million Canadians (16 per cent) aged 15 years and older reported that they had arthritis. With the aging population, this number is expected to increase to approximately seven million (20 per cent) in 2031.

If Wolf ever does need a cane, he’ll have plenty of company.

Dr. Linda Li, research scientist at ARC and a Vancouver-based physical therapist, points out an encouraging trend is that many boomers, like Wolf, have sustained interest and participation in high-level sport over the whole length of their lives; other baby boomers are re-engaging in competitive physical activity as they get older, after having “outgrown” sport in their mid-20s. Part of the reason this is happening, suggests Li, is that boomers see it as “an opportunity to reclaim an identity that they had many years ago.”

Like Wolf, most baby boomers aren’t ready to take their advancing age lying down. Instead, they’re running and swimming and shooting jump shots. Clearly, today’s boomers are much more active than previous generations. And that’s part of the problem.

In short, baby boomers may be asking too much of their joints. All of that running, jumping and pounding can easily damage tendons, cartilage or bone. According to ARC, such injuries often lead to arthritis years down the road. If a person already has arthritis, those sprains, tears and breaks will only add to the pain.

Even if you aren’t an athlete, your joints may suffer from normal wear and tear. According to the most recent data from Statistics Canada, about 23,000 hip replacements and 38,400 knee replacements were done in 2006-07 and that number is expected to grow. Osteoarthritis was the most common diagnosis among hip replacement patients, 29.5 per cent, and knee replacement patients, 40 per cent. ARC research suggests that B.C. will spend more than $250 million a year in 2010 dollars on joint replacement by 2020.

The good news is that with joint replacement surgery, many people with severe arthritis can still lead an active life.

Arthritis experts agree: baby boomers are redefining what it means to age.

“The traditional stereotype is that you should slow down, rest and, for the sake of your body, don’t do competitive sport,” Li explained. If boomers are up for the challenge, “this trend may actually change social norms for what we expect is possible for people as they get older.”

That is, baby boomers will be the most physically active senior generation we have ever seen. What’s important in terms of arthritis prevention for aging athletes and fitness enthusiasts is to remember that medical attention and rehabilitation after injury is also crucial to preventing arthritis types such as osteoarthritis, which affects one out of every 10 Canadians.

Such numbers should sound a warning to boomers everywhere. Arthritis or not, now is the time to start taking care of their joints. Wolf told ACE at the Primary Care Conference that he plans to trim down his rugby-player physique, a step that would take some of the strain off his knees, hips and ankles.

Most of all, he intends to keep moving — sensibly. Whether it’s a brisk walk with the dogs or a bike ride with his boys, regular exercise will keep his joints functioning for as long as possible. With these types of regular physical activity, muscles become stronger, better supporting weight-bearing joints and minimizing pain and stiffness.

Experts at ARC offer the following tips to help baby boomers avoid injuries that increase the risk of arthritis:

  • Before engaging in vigorous exercise, take the time to warm up for three to five minutes with a walk, slow jog or stationary bike ride, and then move your joints through their full range of motion and stretch major muscles, such as hamstrings, quadriceps and those of the upper body.
  • Avoid the “weekend warrior” syndrome. Instead of pushing yourself to the limit two days a week, try to get at least 30 minutes of moderate exercise every day.
  • Use the 10-per-cent rule. If you want to boost your activity level (a noble goal), do it just 10 per cent at a time. If you normally jog one mile a day, next try going 1.1 miles, not four.
  • Invest in good equipment — and yourself. Good shoes and other gear often make the difference between a healthy workout and an injury. If you’re taking up a new sport — tennis, for example — consider taking a class to learn the proper techniques to avoid injury.

Leonard Wolf isn’t willing to just wait for arthritis. He sees his physician regularly and is ready to do anything it takes to protect his joints. In the future, that very same doctor will likely have to help Wolf manage pain and stiffness in his knees and ankles.

Despite the potential pain in his future, Wolf doesn’t regret all of those rugby games in his past. “Sports taught me a lot about teamwork,” he said. Teamwork got him into this situation, and it will help get him out.

-John Esdaile is professor of medicine at the University of British Columbia and scientific director of the Arthritis Research Centre of Canada. Cheryl Koehn is president and founder of Arthritis Consumer Experts.