Aging Schwarzenegger Should Enjoy Full Recovery

Dec. 26, 2006 — -- Arnold Schwarzenegger, the former action movie star and current California governor, will likely recover fully from the broken leg he suffered in a skiing accident on Dec. 23.

This, coupled with the fact that the 59-year-old Schwarzenegger's broken femur was likely a result of high speeds rather than weak bones, should be encouraging news for aging baby boomers who engage in exhilarating sports.

"The message that is really out there now is that, as a society, I think we are coming to view the aging years very differently than we did before," says Dr. Regis O'Keefe, director of the musculoskeletal research center at the University of Rochester Medical Center in New York. "We have a desire in the population to maintain high levels of function."

And continuing medical advances should help support this desire, he says.

"I think that Gov. Schwarzenegger, in maintaining his activity, is a model of what people today can expect as they get older, and I think that the medical and scientific community can deliver on that expectation."

Schwarzenegger underwent surgery on Tuesday morning to repair his right femur. The surgery, known as an open reduction internal fixation, lasted an hour and a half. At 10:45 a.m., Schwarzenegger's surgeons cleared him to resume his daily activities as governor.

"Recovery will take approximately eight weeks, and I expect the governor to fully recover," said Schwarzenegger's orthopedic surgeon, Dr. Kevin Ehrhart, in a statement released after the surgery. "The governor is not in a cast and will use crutches to walk while his leg heals."

Injury Likely Due to High Speed, Not Weak Bones

Contrary to the idea that frailty necessarily accompanies aging, older sports aficionados may still engage in demanding and potentially dangerous pastimes -- as long as they have kept themselves in pretty good shape.

"Fifty-nine is not old, but it's not 25," says Dr. John Messmer, associate professor at the Penn State College of Medicine in Palmyra, Pa. "However, a man who has been exercising regularly and generally is in good health should recover without issues.

"Skiing is an intrinsically dangerous sport," Messmer adds, "and such an injury as this could happen to anyone at any age."

However, since the exact nature of Schwarzenegger's injury has yet to be released, it is unknown exactly how he broke his leg. Also, his recovery could depend on health factors aside from his fractured femur.

"What I don't know about the governor is his other health," Messmer says. "I don't know if he has a family history of blood clots, for example, or his blood pressure or lipid level to know what sort of cardiovascular risk he has. I don't know what meds he takes."

The fashion in which he injured himself could also have implications for strains and other potential injuries in different parts of his body.

"With his muscle bulk, his bones should be strong," Messmer says. "If his bones are strong, the injury might have also affected his hip, knee or back. The force needed to fracture the femur would be transmitted to those areas."

Seniors Can Expect Slower Healing Rate

And though Schwarzenegger may make a full recovery, it is unlikely he will heal quite as quickly as he did in his "Conan the Barbarian" days.

"While we put in metal screws and rods to ensure that the bone heals straight, the actual healing of the bone remains a biological process," O'Keefe says. "And fractures that happen during different times in life have different abilities to heal."

Critical to the bone healing process will be a thin sheath of cells, known as the periosteum, which enshrouds all of the bones in the body. The periosteum contains stem cells which will eventually form the cartilage and bone tissue required to fill the break.

The older you are, the more slowly these stem cells work to repair injury.

"The cells that line your bones as you get older have less of an ability to drive healing," O'Keefe says. "Comparing the governor as an adult to when he was an adolescent, his ability to heal now is slightly slower than it was."

Fortunately for Schwarzenegger, the femur is one of the bones that has a high number of these stem cells. And researchers are currently looking at ways to take advantage of these cells to help patients heal more quickly.

"As we continue to study these stem cells, we will be able to understand why stem cells that are older don't behave in the same way as those that are younger," O'Keefe says.

"Once we understand that process, we can manipulate the stem cells and supply signals that potentially enhance repair."

Changing the Perception of Aging

With continued medical developments, many researchers hope that typical bone breaks experienced by seniors will shift from those attributable to osteoporosis and other forms of bone deterioration to those from episodes like Schwarzenegger's.

"We have previously seen aging associated with arthritis, poor fracture repair. This has been seen as an inevitable part of getting older," O'Keefe says. "As the baby boomer generation ages, what we hope to do is manipulate those types of processes thought of as inevitable in order to correct these processes so people can be more active."

And even before new treatments hit the scene, Messmer says middle-aged Americans may do well to follow Schwarzenegger's example and engage in exciting physical activities -- provided they do so safely, of course.

"Someone who is fit should not limit himself or herself due to age, for the most part," Messmer says. "Balance begins to be affected in the 70s, so something like rock climbing might not be advised. But skiing, tennis, etc., should not be limited just due to age."