Orthopedic surgeons should advocate healthful aging

We can educate our patients about the benefits of exercise, weight control.

Issue: September 2003

ByDouglas W. Jackson, MD

Douglas W. Jackson, MD [photo] --- Douglas W. Jackson, Chief Medical Editor

The aging of America means more people will experience an extended life span. These seniors are looking forward to enjoying these years with a quality of life that includes remaining active.

Much federal funding has gone into research that has extended the life span of Americans. However, we are now presented with the need to support research and programs that will extend the “health span.” Every specialty in medicine will need to focus on benefits that it can apply to our aging population.

Certainly, one of the most satisfying aspects of being an orthopedic surgeon is our involvement in patient care that extends or re-establishes their patients’quality of life. Our discipline has become quite proficient in replacing joints, decompressing spines, correcting internal derangements of joints, repairing ruptured and degenerative tendons, and numerous other procedures.

Education needed

Patients need more factual information and education related to their musculoskeletal health. They are confronted with a multitude of controversial treatments and remedies for slowing or reducing the effect of the aging process.

Diagnostic testing procedures and treatments are discussed in the media everyday that are confusing to put in perspective — from tests for skin thickness and texture to oxygen consumption while exercising. There are heart scans to detect plaque buildup, body scans to detect early tumors, genetic testing for predisposition to disease and laboratory studies to measure different levels of constituents in the blood.

Issues related to growth hormones, testosterone, DHEA, estrogen and progesterone pills, creams and patches remain controversial. Benefits and side effects are discussed in the press and on the Internet. Studies are often conflicting and final answers in most of these areas are yet to be determined.

Exercise, weight reduction increase health span

Obesity is a treatable major health problem confronting our patients and the general population. It currently is one of the most difficult conditions to manage. Patients have to change their eating habits and their approach to exercise. This requires self-discipline. Fewer than 5% of my overweight patients are able to undertake and maintain a significant weight reduction program.

If there were a pill that would reduce weight, increase strength, reduce joint pain, make a person feel better and younger with no systemic side effects, everyone would buy it. Exercise can do all those things, but the majority of people never experience those benefits because exercise requires energy, discipline and consistency.

Most people do not understand what it takes to really exercise nor do they understand the concept of how to change their percentage body fat. Most don’t maintain strength in their small and large muscle groups as they age, and even those who exercise often neglect their spine stabilizers and abdominal musculature.

The effects of aging on the musculoskeletal system are accelerated by loss of aerobic conditioning, strength and flexibility; obesity; and lifestyle choices that include unhealthy activities.

Our specialty is currently seeing an increasing number of aging patients seeking relief for musculoskeletal symptoms and disability. We need to become proactive proponents as clinicians and we need to support the necessary research that documents and develops programs to help maintain the health of the musculoskeletal system. Our challenge is to introduce education for orthopedic surgeons to help prepare us to be leaders in the prevention and slowing of degenerative conditions impacting the musculoskeletal system.

I feel strongly that we need to become even more involved as leaders in finding ways to prolong the health span of the musculoskeletal system. This will require directing more attention to preventing and reducing the effects of degenerative conditions that impact ambulation and reduce participation in desired activities.

Setting an example

We need to become more effective spokespersons, advocating the benefits of exercise and fitness, weight control, stretching, agility and balance. The benefits to the largest number of patients will result from education that leads to lifestyle changes in these areas. As orthopedic surgeons, we see and understand the tremendous differences between biological and chronological age. We see the significant variations in the rates of joint deterioration and loss of function. I feel we will be more effective in educating our patients about the importance of maintaining their musculoskeletal system if we set an example with our personal fitness level.

Along this line, Orthopedics Today will be introducing soon a new feature called “Fitness and Beyond.” These stories will be examples of the myriad ways orthopedic surgeons remain fit and active. We are looking for and will feature stories about people in our profession who have engaged in exceptional fitness activities. Examples might be climbing Denali or a higher mountain, racing a bicycle across America, running a two-hour-and-30-minute marathon, hiking the John Muir Trail or kayaking the inland waterways to Alaska.

Please help by sending information about yourself or a recommendation about another orthopedic surgeon we could interview. I am interested in reading and learning what some of these accomplishments are among our colleagues. Send your recommendations to cowens@slackinc.com.