Age is just a number, but for the “Baby Boomer” generation that number could have a huge impact on your practice. As Baby Boomers age, they are more likely to need your help to adjust to the many changes going on in their bodies. Since Boomers make up the largest segment of the American population at 76 million people, it’s easy to see that they are probably a large portion of your patient total. As chiropractors, it’s our job to support this group of people born between 1946 and 1964, so let’s take a look at how we can offer them the best, specialized care.
As a society, we are growing older; however statistics show that, at birth, most of us have perfect feet. By age 20, 80 percent of those “perfect feet” have developed some type of problem, and by age 40, nearly everyone has a foot condition of some sort! Many foot conditions eventually contribute to health concerns farther up the kinetic chain, especially the generalized condition of back pain. Therefore, it’s in the best interest of both you and your patient to be able to spot potential problems before they are allowed to affect a patient’s health and/or lifestyle.
The Boomers are a comfort-seeking population. They have had access to remarkable technologies and are, therefore, fascinated with the benefits which lifestyle improvements can bring. Their parents’ generation had limited access to healthcare options and so, mostly, learned to “put up with it.”
Not the Boomers. This generation is willing to break that old mold. A 1998 study found that there were more visits to non-medical practitioners than traditional medical doctors.1 This dynamic group of style-makers is willing to explore more relevant options.
Time Passages
The Boomer Generation must also, however, face some facts about its health. This group is aging, and with aging come the challenges and concerns associated with osteoarthritis, diabetes, and obesity. Each of these aging factors affects overall health and well being. Of special significance are the changes in motion and flexibility of the foot and ankle. Excessive strains upon the foot alter the biomechanics of the entire weight-bearing joint complex.
The foot is an area which is particularly sensitive to the effects of aging. As it is the first link between the ground and the body, an aging foot has increased demands on its flexibility and performance. Structural changes within the foot are more symptomatic and pronounced as the patient enters into his or her middle and later years. This is mainly because of the repetitive impact forces that accumulate over time as the foot strikes a hard surface.2 Aging tissues lose their elasticity, and the cumulative strains and stresses place unusual forces into the plantar fascia and even the subchondral bone.3
A properly designed, custom-made orthotic can restore a more balanced foot posture and also reduce the impact forces that enter into the foot.4 Extra cushioning can be built into a flexible, custom-made orthotic, which can dampen the vibration forces that enter the foot during the gait cycle.5 The use of a flexible, custom-made orthotic can greatly aid the aging foot to hold a more neutral posture and also to reduce the noxious forces entering the kinetic chain.
During standing and walking, the lumbar spine and pelvis balance on the lower extremities. If leg or foot asymmetries or alignment problems are present, abnormal forces are transmitted along the closed kinetic/kinematic chain, interfering with spinal function.6 When excessive pronation and/or arch collapse is present, a torque force produces internal rotation stresses to the leg, hip, pelvis and low back.7 This is where the use of flexible, custom-made orthotics is most effective, and can make chiropractic adjustments more effective and long-lasting.
More Trouble
Along with degenerative changes of the joints comes the potential degeneration associated with diabetes. This insidious disease process is especially common to the age group represented by the boomer generation. Diabetes affects the small vessel circulation of the extremities. Tissue breakdown and diminished sensation are consequences of the diabetic process, which means that shoe fit and the amount of cushioning within the shoe are important factors. Repeated friction can go unnoticed and an ulcerative condition could erupt. Diabetes also slows the healing rate; tissue breakdown conditions can linger and become morbid for the patient. An orthotic that has support and adequate cushioning can greatly aid in a diabetic foot. Extra care must be taken to ensure a proper orthotic fit when installing them. All friction points must be evaluated when the orthotics are inserted. The break-in period may need to be lengthened, so that any unusual skin irritations can be addressed.
Obesity and aging are, sadly, nearly synonymous. The North American diet and exercise habits show a trend toward being overweight and even obese. In 1999, an estimated 61 percent of U.S. adults were classified as overweight, and obesity among adults has doubled since 1980.8 Excessive weight places unnecessary strain on the musculoskeletal system. There is noticeable change in the alignment and movement of the load-bearing joints. Altered pelvic posture, sacroiliac mechanics, Q-angle shifts, and foot and ankle dynamics are all changing when constant excessive loads are applied. Hyperpronation of the foot, foot flare on contact, and increased hip abduction are prevalent in the overweight boomer.
In addition, overweight patients have a greater incidence of plantar fascitis, tendinitis, osteoarthritis, and sprains of their feet and ankles.9 A special style of custom-made orthotic may be needed for the obese patient, one which provides a firmer level of flexible support. As well, orthotics may need changing at more frequent intervals. The tendency is for obese individuals to break down their orthotics at a much faster pace.
Made for Each Other
The Baby Boom phenomenon was tailor made for the chiropractor. The largest segment of the population is also the decision-making population. This Boom generation enacts different values than their seniors or the “Generation X-ers” behind them. This is the generation that pushed alternative health practices to the mainstream of society. Practitioners now have the ease of telling a chiropractic story based upon wellness rather than symptom-only care. Boomer patients are delighted to have a dedicated, visionary team that can recommend adjunctive products and services.
The focus for this segment of patients is to “optimize the experience.” Thorough examinations which exceed the confines of the spine are the perfect tools to demonstrate the connected nature of postural alignment and whole health. The prosperity and the technological advantage of these boomers allow them to look far beyond a survival model of health care. Chiropractors can easily and ethically serve the boomers’ growing appetite for health-related products. A custom-made orthotic program is an ideal strategy to provide excellent, supplementary service.
As the Boomer population ages, a growing need and a growing desire to seek balance in healthcare and lifestyle become evident. Take a look at the demographics in your office and realize the special opportunity that exists to care for the Boomers. A simple yet effective custom-made orthotics program could make an important statement of care to this health-conscious generation.
As the Associate Director of Education at Foot Levelers, Dr. Brian Jensen shares more than 20 years of practice experience in chiropractic colleges and seminars around the world. He teaches a common sense approach to gait, posture and biomechanics and how these ideas can be implemented in a wellness based practice. A graduate of Palmer College of Chiropractic, Dr. Jensen speaks internationally on a wide variety of topics, including orthotic therapy, structural preservation, breaking free of the medical model of health care, and innovations in nutrition. Dr. Brian Jensen can be reached at [email protected].
References
1. Astin JA. Why patients use alternative medicine. JAMA 1998; 279(19):1548.
2. Radin EL. Effect of repetitive impulsive loading on the knee joints of rabbits. Clin Orthop 1978; 131:288-291.
3. Radin EL. Effect of prolonged walking on concrete on the knees of sheep. J Biomech 1982; 15:487-494.
4. Kuhn DR, Yochum TR, Cherry AR, Rogers S. Immediate changes in the quadriceps femoris angle after the insertion of an orthotic device. J Manip Physiol Ther 2002; 25(7):465-470.
5. Nigg BM, Nurse MA. Stefanyshyn DJ. Shoe inserts and orthotics for sport and physical activities. Med Sci Sports Exerc 1999; 31(7 Suppl):S421-S428.
6. Keane GP. Back pain complicated by an associated disability. In: White AH, Anderson R. eds. Conservative Care of Low Back Pain. Baltimore: Williams & Wilkins, 1991:307.
7. Hammer WI. Hyperpronation: causes and effects. Chiro Sports Med 1992; 6:97-101.
8. U.S Department of Health and Human Services. Overweight and obesity threaten U.S. health gains. HHS News (press release) 12/13/01:1-4. www.surgeongeneral.gov/news/pressreleases/pr_obesity.htm
9. Frey C, Chan C, Carrasco N. Obesity: Do weight gains lead to lower extremity pains? Biomechanics 1996; 3(1):30-34, 89.