I'M NOT ONE of the world’s greatest baseball players, I don’t use steroids, and I’ve never dated Cameron Diaz. Still, I have something in common with baseball superstar Alex Rodriguez: femoral acetabular impingement, or FAI, a hip condition typically associated with high-performance athletes. In my case, it might as well be called boomeritis.
Health-conscious boomers’ dedication to exercise—and stubborn insistence that 55 is the new 35—is generating big business for orthopedic surgeons and physical therapists.
Emergency room visits due to sports injuries rose more than 30 percent in the 1990s. By 2003 a national survey found that sports injuries had become the number two reason for visiting a doctor, after the common cold. As our odometers spin, and active boomers exceed the evolutionary warranty on our joints, the number of knee and hip replacement surgeries has soared.
I’m no athlete, but I have participated in the “Suburban Triathlon” of gardening, yoga and personal training. I’ve also danced thousands of hours since I first put on a pink tulle tutu at age 4 and twirled, discovering the joy of propelling myself through the universe with grace and speed. At 50, I felt as strong and energetic as ever. So it seemed like a good idea to turn my Bethesda backyard into some remembered vision of a French park, although the transformation entailed using my left foot like a battering ram to jam a shovel into the hard, clay soil of our garden. A few years later, a trainer at my gym had me doing numerous squats and Spider Man crawls, further stressing my hips. I felt occasional twinges of pain in my left hip. I shook them off.
Maria Kozloski is smarter than I am, and not just because she majored in math at the Massachusetts Institute of Technology. Kozloski, global head and chief investment officer for private equity funds at the International Finance Corporation, is a longtime runner. When her three children were still infants and toddlers, she trained for a marathon and finished in 2 hours, 56 minutes. Today, at 50, she runs up to 60 miles weekly. She sometimes commutes from her Bethesda home to the District by running along the C&O Canal.
She relies on holistically-minded professionals to help maintain athletic performance while avoiding serious injury. Weekly, she visits Terrel Hale, a licensed massage therapist and personal trainer who uses something called Active Release Techniques to help runners recover from overuse injuries and improve performance. Hale, who charges $150 a session and sees clients in his Rockville home and Georgetown office, evaluates the tightness and movement of Kozloski’s muscles and tendons. Then he uses pressure and stretching to head off problems. “He’s a great tuneup,” Kozloski says.
Kozloski recently paid $200 to George Mason University’s Sports Medicine Assessment Research & Testing (SMART) Lab to perform a 3-D assessment of her gait. The lab recorded her running and compared her movements with an international database of walking and running injuries to pinpoint areas of weakness or inflexibility that she needs to correct.
I never thought about my gait or its impact on my joints until it was too late. Eventually, my hip pain prompted my insurer, a staff-model HMO, to send me to one of the orthopedic surgeons it employs. That surgeon ordered an MRI of my left hip that, it later turned out, showed FAI, a condition in which abnormal contact between the ball and socket of the hip results in friction that damages the joint.
If that first surgeon realized I have FAI, he didn’t tell me. When I asked why my hip hurt, he shrugged. A second orthopedic surgeon who works for my HMO later reviewed my MRI and told me that it showed FAI in my left hip. She also told me, frankly, that she worried that the open, invasive surgical hip repair that she could do might leave me worse off than I was—and that she didn’t know how to do the minimally-invasive arthroscopic hip surgery that A-Rod underwent on both of his hips.
So I turned to the Hospital for Special Surgery in New York City, where A-Rod had one of his surgeries. I paid out of pocket for testing and consultation with one of the world’s leading hip surgeons. He was kind. His news was grim. The two primary causes of serious arthritis leading to total hip replacements are FAI and a congenital hip deformity called dysplasia. I have both, he told me. I have them in both hips, not just the left.
Finally, I understood my predicament. If I plot a graph of my life expectancy versus the life expectancy of my hips, the lines head in opposite directions. “This is the calm before the storm,” the surgeon warned. My best hope to avoid double hip replacement was to have arthroscopic surgery to correct my FAI and repair some of the damage it had done.
I didn’t cry. I came home, put Sinatra on, and asked my husband to dance me around the kitchen.
My HMO declined to pay for the hip-saving surgery at the Hospital for Special Surgery. My primary care doctor asked a supervising orthopedic surgeon who works for my HMO to meet with me to discuss options. He refused, telling my primary care doctor that this meeting would constitute a third opinion, and my plan didn’t cover that.
Then I cried. I still have no idea what I’ll do. Now when I weed my beautiful garden, I lie down on my side so I don’t stress my hips by bending repeatedly.
Abdul-Karim al-Jabbar, 41, knows the exhilaration of athletic accomplishment and the sobering reality of reaching one’s physical limits. A former star running back at UCLA, he played in the NFL from 1996 to 2000. He endured multiple knee surgeries before he took himself out of the game. Now he’s a popular personal trainer (www.thencwc.com) who helps clients vary their movements to avoid injuries. “Exercise is a stress,” he says. “It has to be appropriately applied.”
One of his clients is William Conti of Chevy Chase, a mergers and acquisitions lawyer who heads BakerHostetler’s business practice in Washington, D.C. Conti belongs to three gyms and works with three trainers each week, which costs him up to $20,000 annually. One trainer helps Conti build strength and conditioning through boxing. A former collegiate swimmer helps the lawyer perfect his swim strokes. Al-Jabbar works with Conti on sprinting, emphasizing speed and explosiveness. “I’m in better shape now than I was in my 20s, 30s or 40s,” says Conti, 61.
Conti knows he’s supposed to listen to his body and slow down when it tells him to. “From time to time, I still tell my body, ‘Shut the hell up and do what I tell you,’ ” he jokes.
“You know where all this is ultimately heading,” I say, thinking Conti’s going to need knee surgery.
“Yeah,” Conti replies with a sardonic laugh. “Death.”
But not today. When Conti was 12, he’d pretend he was Yankees great Mickey Mantle. He’d stand in his backyard, hurl a baseball straight up into the blue yonder, then wait—bat in hand, anticipating—as the spinning white orb came back into view. Then he’d thwack that ball with all his might.
“I’ve really never lost that feeling,” Conti says. “I’ve never grown out of that and hope I never do. I’m still that kid who wants to be Mickey Mantle.”
April Witt (aprilwitt@hotmail.com) is a former Washington Post writer who lives in Bethesda.
