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Category: Oblander Chiropractic

Chiropractic Safer than Medical Care for Elderly

Chiropractic Safer than Medical Care for Elderly

Many studies have found that chiropractic care is a safe and effective treatment method when dealing with a number of spine-related issues. The American Chiropractic Association even lists a number of research studies on their website that show that it is a valuable treatment method for easing (and sometimes completely resolving) back pain, neck pain, headaches, and more.

While all of this is good news for professionals that practice in the chiropractic field, some researchers wondered if chiropractic was just as safe for elderly patients as it is for younger patients experiencing these types of problems. So, they set out to find the answer, which they did via a retrospective cohort study funded by NIH and the National Center for Complementary and Alternative Medicine, and also which was subsequently printed in Spine upon its completion.

What researchers wanted to discover was whether the relationship between the risk of injury to people 66 years old and older when engaging in chiropractic care was higher than, lower than, or equal to the risk of injury to this same age group after undergoing medical care by their primary care physician. To find their answer, they studied data on Medicare B patients who went to the doctor in 2007 for a neuromusculoskeletal issue, evaluating their risk of injury seven days post-treatment.

They discovered that seniors that received chiropractic care had a 76% lower rate of injury within seven days of treatment when compared to the subjects that met with their primary physician as a result of a neuromusculoskeletal complaint. Researchers also pointed out that they found that males contained within the research group, older study participants, and those with a higher Charlson co-morbidity score were most at risk of injury within the week after acquiring a neuromusculoskeletal issue.

Additionally, certain medical conditions raised the risk of injury, even after chiropractic care. Therefore, chiropractic professionals should consider whether treatment via spinal manipulation is best for “patients with coagulation defects, inflammatory spondylopathy, osteoporosis, aortic aneurysm & dissection, or [those who have engaged in] long term use of anticoagulant therapy” as the increased risk may not be worth the benefits.

Whedon JM, Mackenzie TA, Phillips RB, Lurie JD. Risk of traumatic injury associated with chiropractic spinal manipulation. Spine 2014;Dec 9.

When Are Antibiotics Appropriate and When Should I Avoid Using Them?

When Are Antibiotics Appropriate and When Should I Avoid Using Them?

People are becoming increasingly aware of the dangers that can result from the overuse of antibiotics. When antibiotics were first discovered in the early 20th century, researchers believed that they had found the key to conquering many deadly diseases. Since that time, antibiotics have certainly helped to cure diseases that once wiped out large parts of the population. However, there is growing evidence that antibiotics are now being used too frequently, and that they are often being used in inappropriate circumstances. This has led to many previously curable diseases becoming antibiotic-resistant, which means that a cure now requires the use far stronger antibiotics. In fact, some diseases have now become resistant to nearly all antibiotics. It is obvious that if antibiotic use continues in this way, we may have a major health crisis on our hands.

The first thing to be aware of is that antibiotics are not effective in the treatment of viruses. They only treat bacterial infections, certain fungal infections and parasites. For diseases such as the common cold, flu or bronchitis, antibiotics are completely ineffective and their use in cases such as these will only contribute to the development of antibiotic-resistant bacteria. You should not ask your doctor to prescribe antibiotics if you have a sore throat or the stomach flu, for instance. According to the Centers for Disease Control and Prevention (CDC), antibiotics were prescribed for an acute respiratory infection in 68% of visits to the doctor. However, 80% of those prescriptions were unnecessary.

Antibiotics are often an appropriate treatment for conditions such as severe sinus infections that last longer than two weeks, ear infections, bladder infections and skin infections. These are frequently due to a bacterial or fungal infection, and treating them with antibiotics is effective.

If you have been prescribed an antibiotic, it is very important that you take it exactly as directed by your physician. If your symptoms happen to clear up before the entire course of antibiotics is completed, you must still continue to take them as prescribed. This is because there may still be a few lingering bacteria in your system, and—if they are not all killed—the strongest ones may survive to produce new generations of ever stronger bacteria that might make current antibiotics less effective.

Some doctors feel pressured by their patients to prescribe something, whether it’s really going to be helpful or not. A study published in the journal Pediatrics found that pediatricians will prescribe antibiotics for children 62% of the time if parents expect them to, and only 7% of the time if the parents do not expect an antibiotic prescription. Do not put pressure on your doctor to prescribe antibiotics for your condition. He or she is the best judge as to whether antibiotics are appropriate.

Also, keeping adjusted helps keep your immune system at its best. To avoid catching colds and other viruses, be sure to keep you and your family adjusted! Call our office at 406-652-3553 if you need to schedule an appointment with Dr. Oblander!

Follow-up on Standing Desks

Follow-up on Standing Desks

We recently posted about standing desks. For those of you who are looking for some good information on standing desks, today we are sharing a review on some standing desks. Standing desks are a great option where they are allowed! Standing desks can be of great benefit by allowing greater circulation while you are working at your desk! Wonderful for those of us who spend a considerable amount of time sitting at a desk!

Here’s the link to the review: http://www.reviews.com/standing-desk/

Spinal Health at the Gym—Form Matters!

Spinal Health at the Gym—Form Matters!

Whether you are an athlete training for competition or someone who visits the gym regularly just to keep fit, protecting your back and spine from injuries during workouts is important. A large-scale University of Arkansas study found that after injuries to the hand, injuries to areas ranging from the neck to the lower back were the most common type of gym-related injuries.

Back injuries at the gym are more common today due to the large amounts of time we spend sitting at a desk or hunched over a computer. According to personal trainer Justin Price, a specialist in functional fitness and corrective exercise, “If someone is rounded throughout the day in their upper back, and then they go to the gym and do an overhead shoulder lift standing, their upper back cannot extend properly. They straighten and arch upward from their lower back, which has a nervous breakdown because it’s getting all the stress.”

Price suggests that in order to avoid injury you consider getting a personal trainer who can show you the proper way of performing exercises and using equipment. The most important way to maintain good spinal health is to strengthen your core muscles. These are the muscles that lend strength and support to the spine, and which tend to become weakened with long periods of sitting. Following are a few tips on how to use proper form when exercising or lifting weights in the gym.

Tighten your gluteus muscles – When performing a squat, deadlift, or during pushups, be sure to squeeze your glutes. This ensures that the muscles connecting your lumbar and sacral areas are locked so your hips and lower back move as a single unit. Otherwise there is a tendency for the lower back to curve, with the vertebral discs being exposed to more stress than they are designed to handle.

Tighten your abs – So as to keep your spine from arching too much in either direction, tighten your abdominal muscles like you are preparing to be punched in the stomach. This will provide stability to the spine as you bend and lift.

Pull your shoulders down and back – A rounded upper back is one of the leading causes of back injury. It increases pressure on the front side of the vertebral disks, increasing the risk of disc herniation.

Keep hips and shoulders aligned – Back injuries happen more often when twisting and bending. Ensure that your hips and shoulders move as one unit. If you need to change direction, lead with the hips and the shoulders will follow. If you lead first with the shoulders, the hips tend to fall behind, too late to keep from overstraining the low back muscles.

 

Chiropractic Care and Professional Baseball: The Philadelphia Phillies and Dr. Michael Tancredi

Chiropractic Care and Professional Baseball: The Philadelphia Phillies and Dr. Michael Tancredi

When it comes to helping elite athletes prevent and recover from injuries—as well as achieve peak performance—chiropractic care can offer many advantages. That’s why large numbers of professional and college sports teams throughout the U.S. have turned to chiropractors over the past decade. The Philadelphia Phillies is one such team, and Dr. Michael Tancredi is one such chiropractor. As a Doctor of Chiropractic, a Certified Chiropractic Sports Physician, an Active Release Technique Instructor and Practitioner, and a certified athletic trainer, Dr. Tancredi clearly understands the valuable role that chiropractic care can play in keeping teams healthy and performing at their best.

By almost any measure, Dr. Tancredi has had a long and successful career in sports medicine. He has worked extensively with the Philadelphia Eagles, Philadelphia Phillies, and Villanova University. While Dr. Tancredi has accomplished a great deal in his professional life (and he continues to work with patients through his practice in Broomall, Pennsylvania), he is perhaps best known as the chiropractor who went all the way to the 2008 World Series as a consultant with the Philadelphia Phillies. From 2008 through 2010, he was a chiropractor and Active Release Technique provider for the team.

Cole Hamels, a member of the 2008 Phillies team, has been very vocal about the difference chiropractic care has made for him. “Being introduced to chiropractic care has definitely helped my game. When you add it with a lot of the physical therapy exercises and the in-game exercises, I think it just prevents a lot of injury. I went through a lot of injury in my career, and the first time I actually was introduced to chiropractic care, it pretty much kept me on the field. It’s something that helps me feel much better when I’m on the field and off the field.”

As a pitcher, Hamels is particularly aware of the complex biomechanics involved in throwing a baseball, and recognizes how the larger muscle groups—not just the shoulder and elbow—must work together to perform well. “Your body starts from the ground up, and in order to pitch, you have to use everything. You have to have a good back in order to get the good torque. Most of your power comes from your core.”

It’s a challenge staying healthy through a 162-game regular season, and players at the elite major-league level do what they can to avoid injuries. Hamels recalls how chiropractic care became popular among his teammates and coaches. “It’s another way to help us get out on the field… We’ve seen more and more players start to go in to get adjustments, to get the ART. And I think that’s good for our whole team because you want them to be able to go out on the field every day because we’re very good at what we do, but you’re not going to help the team out when you’re not playing.”

In a brief interview published in ACA Today, Dr. Tancredi described his own experience with the Phillies and explained why chiropractic care is such a good fit for professional baseball. “It was a dream job and a dream season. The whole sports medicine staff was phenomenal. They were all really open to the benefits of chiropractic care. Athletes at this level rarely have an acute injury. However, a little hamstring pull can turn into a major problem when they have no time off. Baseball’s schedule is grueling in that the players are on the field 28 out of 30 days a month, so we have to do what we can to help them heal while keeping in mind the long-term consequences. Chiropractic has cut the injury rate; the players love it, the athletic trainers see how effective it is and the orthopedic surgeon is totally open to my suggestions—it’s a win-win situation.”

Whether you’re playing professionally or at an amateur level, baseball puts unique demands on the body’s musculoskeletal system, from asymmetrical movements (throwing and hitting) and extreme acceleration and deceleration to sudden impacts. Take it from the Phillies and Dr. Michael Tancredi, chiropractic care can help players stay healthy and perform at their best.

If you need to make chiropractic a part of your success protocol, be sure to give our office a call at 406-652-3553 to schedule your appointment with Dr. Oblander!

 

Fear or Phobia: What’s the Difference?

Fear or Phobia: What’s the Difference?

frightened-woman

It’s normal to have fears. Fear is a useful emotion that keeps us from doing things that may be harmful or dangerous. Our species continues to exist today because our earlier ancestors had a healthy fear of certain types of predators, environments and situations. In the modern world, many of those primal fears have become much less relevant. Nevertheless, quite a few of us still have a lingering apprehension of spiders, snakes, darkness, heights or other things that we perceive to be dangerous. For most people, this instinctive fear is just quirky or uncomfortable—something we can usually avoid or overcome without too much effort. But what if this apprehension becomes all-encompassing and interferes with daily life? When this happens, you may be dealing with a phobia.

Psychologists define a fear as being “an emotional response to a real or perceived threat,” whereas, according to the Oxford English Dictionary, a phobia is “an extreme or irrational fear of or aversion to something.” Note the words extreme and irrational. A phobia keeps you from living your life as you normally would if the feared situation were not present. For example, you may become nervous or agitated in small or confined spaces and generally avoid taking the elevator. But if that fear is severe enough that it keeps you from taking your dream job because you’d need to use an elevator every day to get to your office, then you likely have a phobia (“claustrophobia”).

Symptoms of a phobia can be both mental and physical. In some cases, just thinking about the thing you fear can bring on the fight-or-flight response. Phobia symptoms often include general anxiety, trembling and feelings of nausea. Your heart may begin pounding and you may start sweating, feeling lightheaded, and breathing so quickly that you begin to hyperventilate. You may also feel an intense need to escape, feel like you are going to die, or fear losing control. Even though you may understand that your phobia is irrational, you still have no ability to stop it.

Not all phobias interfere with the everyday lives of people who have them. A phobia of snakes (called “ophidiophobia”), for example, probably won’t matter much to a city dweller unless he or she visits the reptile house at the zoo. However, a phobia of crowds (“enochlophobia,” “demophobia” or “ochlophobia”) could be a big problem on city streets or in the subway.  Other phobias can have a significant impact on anyone who has them. For about 3% of the population, their fear of doctors (“iatrophobia”) is so great that they avoid any form of healthcare whatsoever, including preventive care. Obviously, this can put their health and even their lives at risk.

If a phobia is affecting your day-to-day activities, then it may be time to seek professional help. Therapy for phobias has been shown to be remarkably effective, and you may also be able to use some self-help strategies on your own to combat the problem.

One of the best ways to begin conquering a phobia is to expose yourself to the thing you fear in a gradual, controlled manner. For example, if you have a phobia of spiders (“arachnophobia”), first look at a few pictures of spiders. Then watch a short video featuring spiders. When you are comfortable with that, perhaps visit a zoo and look at them through the glass. Relaxation techniques such as slow, deep breathing and meditation can help when you are confronting your fears. The more frequently you are exposed to the thing you fear without actually being harmed, the more quickly your phobia is likely to disappear. This doesn’t necessarily mean that you are going to become a fan of spiders, but at least you will have conquered the irrational part of your fear that gets in the way of you living your life.

 

What Is Immunotherapy and How Can It Help with Food Allergies?

What Is Immunotherapy and How Can It Help with Food Allergies?

young-parents-feeding-child

Food allergies affect over 15 million Americans, including 1 in every 13 children under the age of 18. The symptoms of these allergic reactions can range from minor (e.g., itching, swelling of the lips, intestinal cramps, diarrhea, and vomiting) to major or even life-threatening (e.g., development of hives and rashes, tightening of the throat to the point of being unable to breathe, significant drops in blood pressure).

Having such an allergy—or being the parent of a child with such an allergy—can impose unwelcome lifestyle limitations and cause a great deal of anxiety. At present, there is no known cure for serious food allergies that works for everyone. This means that the best approach for the time being is to completely avoid the food product to which you or your child has an allergic reaction. However, this is not always practical or possible to do. That’s why the majority of “treatments” currently available focus on managing the symptoms after an attack has taken place. For instance, individuals with serious food allergies may carry an auto-injector filled with epinephrine (adrenaline) with them at all times, just in case.

Naturally, because of the seriousness and the prevalence of food allergies, a great deal of research is being conducted on treatments to desensitize individuals to the foods they are allergic to. This may effectively “cure” the allergy for some sufferers. One of the fields that shows promise is the study of immunotherapy (more precisely, low-dose immunotherapy), in which extremely small amounts of the allergen are administered to allergy sufferers over time. The basic idea behind the experimental treatment is that the body will develop a tolerance to these low doses and that the allergic reaction will gradually cease.

The first work in immunotherapy was undertaken in the 1960s in England by Dr. S. Popper, who was trying to cure allergic reactions to pollen by injecting patients with low doses of the allergen in combination with the enzyme beta-glucuronidase in an approach called “enzyme potentiated desensitization” (EPD). While the then-experimental treatment showed early success, its use in the U.S. was suspended by the FDA for administrative reasons in 2001. However, follow-up work continued and an enhanced American version of the EPD injection called Low Dose Allergens (LDA) was later introduced.

The obvious drawback of this type of therapy is that the doses have to be injected by a physician. It is also necessary for patients to avoid outside exposure to larger doses of the allergens and to many medications while the treatment is underway. However, other researchers have continued to study desensitization via immunotherapy with the goal of finding other mechanisms of administering the low-dose allergens, such as oral medications, sublingual (under the tongue) medications, and others.

Some of the most promising work in this field is being performed at Stanford University School of Medicine by Kari Nadeau, Associate Professor of Allergies and Immunology. Nadeau is working with children afflicted with peanut allergies. Her approach is to give them minute doses of the peanut allergen and gradually escalate the doses over a period of months in the hope of them eventually developing immunity. Up to this point, Nadeau’s technique has produced positive results for many patients, but it does appear to have limitations. First, the therapy doesn’t seem to offer a permanent “cure”. Patients must continue to take low doses of the peanut allergens or risk losing their immunity. If they stop for more than a few days, the allergies can come back. Second, the treatment itself is time-consuming and often expensive.

While the jury is still out on immunotherapy, the concept shows promise. However, progressing from concept to proven treatment is clearly going to take much more work. As it stands today, some immunotherapy approaches work for some patients but don’t work for others. Plus, there are questions about how long immunity actually lasts and whether it must be maintained or periodically boosted. This is clearly a very important consideration since patients could run the risk of unknowingly losing immunity and coming into contact with the allergen, allowing it to trigger an unexpected—and potentially serious—attack.

So if you suffer from food allergies and are looking for a way to diminish them, the best advice we can offer at this time is to continue following the research and to consult with your own healthcare providers about the potential benefits and risks in your own case. If you do decide to pursue immunotherapy, be sure that it is being administered and overseen by well-trained medical professionals who can monitor progress and watch for side effects.

 

Second Impact Syndrome Explained

Second Impact Syndrome Explained

The Mayo Clinic describes second impact syndrome (SIS) as a complication arising from a concussion. It occurs when someone experiences a second concussion prior to fully recovering from the initial one. With SIS, “typically fatal brain swelling” occurs. R.C. Schneider first described this condition in 1973, but it wasn’t until 1984 that someone gave it the name, “second impact syndrome”. The condition is rare enough that only 21 cases had been cited in the literature up until 2003.

When a concussion takes place, the levels of various chemicals in the brain are changed. This altered state is believed to contribute to a person’s susceptibility to second impact syndrome. Because it normally takes approximately one week for the chemical levels in the brain to return to normal after a concussion, the patient should wait at least this long before returning to any activity that might result in another concussion. But one week is a minimum. The time it takes to recovery fully from a concussion is highly variable and depends on both the nature of the injury and the patient involved. For this reason, it is vitally important that athletes not return to sports while symptoms of a concussion persist and that they receive clearance from an appropriately trained healthcare professional before resuming any sort of risky activity.

NHL star Sidney Crosby learned a lot about concussions first-hand. While playing with the Pittsburgh Penguins in January 2011, he received a concussion. He suffered from a second one only four days later. It took him 11 months to fully recover. Crosby said, “With concussions there is not generally a time frame or a span where you’re feeling better. You feel like you’re getting better and it can be one day and you’re back to where you started. It’s a frustrating injury.” It wasn’t until he was treated by chiropractic clinical neurologist, Ted Carrick, DC, that Crosby recovered from all his symptoms.

Even the mildest of concussions can lead to second impact syndrome, because it’s not the strength of the impact that is the greatest danger. An impact of any force while the brain is still recovering can result in the catastrophic swelling attributed to the syndrome.

Most cases attributed to SIS occur in those who are not yet fully grown. Children and adolescents are thought to be the most susceptible with adolescent athletes at greatest risk for second impact syndrome.

Some researchers have recently raised questions about whether or not SIS actually exists. In their own analysis, they concluded that a majority of cases they examined did not actually meet the diagnostic criteria for SIS. They also found that in some cases the reports of first impact were incorrect or unreliable. While their findings have led to some controversy in the medical community, it should be pointed out that no one has disproven the existence of the syndrome.

Whatever the controversy, it’s difficult to argue against prevention and an abundance of caution given the potential dangers associated with concussions (and multiple concussions). If you’re an athlete, the first step is to wear appropriate safety equipment for the sport you’re playing. For certain activities (such as football, baseball and cycling), a helmet is essential. On-field awareness and proper technique can also go a long way toward preventing head injuries. However, it’s important for players, parents and coaches to recognize that even helmets, good supervision and expert training are no guarantee against initial concussions. They are a risk that can be managed but never wholly eliminated.

When it comes to preventing subsequent concussions, though, there are three additional steps many communities have taken to protect young athletes:

  • Requiring responsible adults to receive concussion-awareness training so that they can recognize the signs of a potential concussion.
  • Requiring officials, coaches and managers to remove injured players from the field when a concussion is suspected.
  • Requiring the approval of an appropriately trained healthcare professional before allowing any athlete with a suspected/actual concussion to return to sports-related activities.
Healthy Lifestyle Choices Are a Team Effort for Couples

Healthy Lifestyle Choices Are a Team Effort for Couples

couple-playing

These days, with divorce statistics skyrocketing, it’s easy to focus on the “for worse” part of the traditional marriage vow. But the simple fact remains that a good marriage—or a healthy long-term relationship of any kind—brings lots of benefits to both partners. So we thought it would be a good idea to remind our readers about the “for better” aspects of marriage—particularly as they related to health and well-being.

As sociologist Linda Waite puts it, “Marriage is sort of like a life preserver or a seat belt. We can put it in exactly the same category as eating a good diet, getting exercise, and not smoking.” Your relationship can provide an opportunity for partnership in more areas than sharing finances and raising children. You and your partner can work together to improve each other’s health and state of well-being. Here are a few tips from health experts to help you do this.

  • Exercise together. When couples meet, chances are each of them has his or her own regular exercise regimen. And chances are they involve different forms of exercise. Just as an example, she may prefer aerobics or running, while he prefers sports like golf and tennis. Well, here is an opportunity to “cross-pollinate” and for couples to try each other’s exercise regimens from time to time. Naturally, working out together also tends to keep both parties exercising regularly, because you’re doing it as a team, not on your own. If it’s looking a little chilly outside, you might be tempted to skip your evening run if it’s just you, but if you know that your partner is counting on going with you, you might just go anyway.
  • Learn from each other’s food preferences. Some studies have shown that in traditional marriages, men tend to eat better after marriage than before. This may be due to the fact that men typically haven’t been taught to cook in the home as young boys in the same way that girls traditionally have (though there are abundant signs that girls and young women now share men’s unfamiliarity with the kitchen). So eating—whether at home or at a restaurant—can become an exercise in learning from your partner’s tastes, and possibly expanding your own. Think you hate broccoli? Well, that was before you tasted your spouse’s recipe for it, right? Eat too many salty or sugary snacks while watching TV? That was before your partner shared their recipe for veggie snacks with the cucumber-coriander dip. As a general tip, health experts say you should look carefully at your partner’s food choices and follow the lead of the person with the healthier diet.
  • Lose weight together. Just as your relationship provides an opportunity to inspire each other when it comes to exercise, it can also be a godsend when one or both of you needs to drop a few pounds. Agree on your mutual weight loss goals, and then go shopping together, and stock your kitchen only with foods that support those goals. Whether you’re trying to cut down on sugar, fat, salt, or other foods that help to keep weight on, working together to stick to a healthier diet can be a lot easier than doing it on your own.
  • Don’t forget the V word. Vacations. Many men—and increasing numbers of women—find themselves in the work rut and fail to find time on the calendar for vacations. Then they wonder why they get sick or find themselves depressed. Planning a vacation together gives both parties the opportunity to figure out just which destinations and activities best suit their preferences and their health goals. Going on these vacations works magic; in one study of 12,000 men, those who took yearly vacations had a significantly lower risk of death than those who did not.
  • Learn things together. Many studies are proving the wisdom of “use it or lose it” with regard to brain health. And one of the proven ways of “using” your brain and thus keeping it free from cognitive degeneration and Alzheimer’s is to keep learning. Again, this is easier as a team than on one’s own. We all know how easy it is to veg out in front of a TV alone, but if you’ve signed up for a language course or have joined the same weekly book club as your partner, you’re more likely to actually keep learning.
  • Go to bed together. No, we don’t necessarily mean “go to bed and have sex” together, although that’s good for your mutual health, too. Instead, studies have shown that couples who have similar sleep schedules are healthier and have fewer incidences of common diseases. Chronic sleep deprivation is becoming a national public health issue, so if you can work out compatible sleep schedules with your partner, chances are it’ll make both of you healthier.
  • Laugh a lot. Let’s face it…how many of us laugh out loud when we’re alone? Do it too much, and people might even begin to think you’re weird. But if you’re like most people, one of the reasons you chose your partner is because he or she makes you laugh. There have been numerous studies that have shown that the more genuine laughs you have per day, the healthier your probably are. So keep amusing each other, and keep laughing at each other’s jokes. It might just provide the mechanism for laughing together for the next fifty or more years, and what’s not to like about that?
Most Effective “Low Impact” Cardio Exercises

Most Effective “Low Impact” Cardio Exercises

Why “low impact” cardio exercises? Imagine reaching your “golden years” with a buff beach body only to be told that you can’t jog or run anymore because your knee cartilage has been worn thin or you have damaged vertebrae. The last thing you want to do is ruin your body while trying to stay in shape. Here we present some good low impact cardio exercises that can help you maintain a healthy cardiovascular system without causing damage to your musculoskeletal system.

Walking—This simple exercise places far less stress on the knees than jogging, running or pounding the stairs. If this sounds too boring, try changing your route. Explore different streets or roads. Also, you might take this to the next level and include hiking on trails or through the woods. Be sure to follow experts’ recommendations about hiking dos and don’ts. Add extra energy to your routine by swinging or rotating your arms to the sides. Involving your upper body as you walk can get your heart beating more vigorously.

Speed Walking—It’s impossible to do speed walking without involving the upper body. This is low-impact movement on rocket thrusters. The most efficient position is to keep your elbows bent at a 90-degree angle and be sure they remain close to your body. Be sure to stick to flat, smooth surfaces to reduce the chances of injury.

Cycling—For even less impact, take your bicycle out for a spin. If your bicycle is properly adjusted to your size, there should be no strain on your knees. You can cover far more territory, do more sightseeing and get lots of cardiovascular benefit.

Stairs—Walking up stairs is a powerful way to work your body. Don’t become impatient, though. You don’t want the walking to become jogging. That would turn your low impact routine into high impact. Make certain you softly plant each foot in turn on the next step and use the strength in your legs to push you upward.

Swimming—If you’re just starting an exercise program or returning after years of relative inactivity, swimming is an excellent low-impact exercise option. Taking to the pool can build up vast reservoirs of cardiovascular health because swimming can work the entire body, depending on the strokes you use.

Dancing—Take a dance class. Whether you’re into ballroom, tap, ballet or modern dance, you can get a low impact workout while having fun with others.

If you already suffer from thin cartilage, don’t let that stop you from exercising. One study did MRIs on 50–80 year olds, all healthy men. The results showed that more exercise led to thicker knee cartilage. The consensus was that exercise helped to repair cartilage deficiencies. Everything else being equal, the body is amazing in its ability to repair itself. And these low impact exercises can work wonders for your long-term cardiovascular health.

Remember that one of the best things you can do for your health is to also get adjusted regularly!