Take South Florida's enticing tropical climate, add an improving economy and throw in the booming popularity of high-intensity workouts like Insanity, CrossFit and Zumba, and what do you get?
A whole lot of injuries, area orthopedic surgeons say.
The perfect storm of fun, sun, fitness and torn ligaments has a season in South Florida, and it peaks about now, when year-round residents and snowbirds alike get out to enjoy the cooler temps.
"With the temperature dropping here in South Florida, people are jumping headfirst into a range of outdoor activities without adequately preparing," Boca Raton orthopedic surgeon Dr. Eric Lloyd said. "After spending the summer indoors and doing very little physical activity, their bodies are not ready and need to be eased into athletics and exercise."
The "weekend warrior" injuries — named for, but not exclusive to, the fitness buffs who cram their workouts into the end of the work week — span the demographic spectrum, doctors say. But they are becoming increasingly common in people in their 50s and 60s — the years when exercise enthusiasts are beginning to come face to face with the realities of age.
"There's no question I am seeing more people who are older in years, but they're maintaining the same level of activity they did in their younger years," said Dr. Jonathan Levy, chief of orthopedics at Fort Lauderdale's Holy Cross Hospital. "Their bodies are not keeping up with their desire to play."
Craig Romer can attest to that. At 51, the Delray Beach commercial mortgage broker has had to come to terms with the effects of age after suffering a separated shoulder and two meniscus tears in the past few years. Though he sustained some cracked ribs and tweaked ankles playing ice hockey most of his life, the shoulder injury was the first time he required surgery.
"I fully recognize that my age is a factor in the activities I'm doing," said Romer, adding that he's pared back his ice hockey playing from three nights to once a week. "I can't compete at the level I used to compete at."
Dr. Marc Bergman, an orthopedic surgeon and sports medicine specialist in Boca Raton, thinks the increase in such injuries is rooted in America's improving economy, which has encouraged more people to retire early to South Florida. Many of them are relishing the area's pro-fitness climate, to their own peril.
"A lot of these people, 55- to 65-year-olds, are getting into Zumba, they're getting into CrossFit, and they're just going crazy," Bergman said.
The high-intensity programs are "great workouts," Hollywood orthopedic surgeon Dr. Johannes Blom said, but a lot of them require jumping, heavy lifting and lots of fast, unconventional movements, often with inadequate warmup preparation or training in proper techniques. "The older population doesn't handle that well."
The typical injuries doctors are seeing are the result of overuse, often over time — knee ligament tears, sprained ankles, torn rotator cuffs, pulled muscles.
"As you get older, the collagen in your tissue changes," said Dr. Daniel B. Chan, an orthopedic surgeon at Memorial Regional Hospital in Hollywood. "It doesn't have as much elasticity as when you were younger."
So you could be performing the same move you have for years, and that last swing of the racket or step of the foot can lead to what Levy calls "the straw that broke the camel's back kind of the thing" — a sudden tear in a tendon or ligament.
There was a time such injuries were uncommon in people in their retirement years, said Dr. Erol Yoldas, an orthopedic surgeon at Broward Health Medical Center and Broward Health Imperial Point in Fort Lauderdale. Now, though, people in their 60s, 70s and older are enjoying an active lifestyle.
"We have a generation of people who are really into fitness, and they see no reason to go quietly into the night, so to speak," Yoldas said. "So that's parlaying itself into a situation where we're seeing more of these injuries."