We hope all of our patients and friends have a wonderful Valentine’s Day!
We hope all of our patients and friends have a wonderful Valentine’s Day!
If you are middle-aged (40-60, by some definitions) or older, here’s 15-second self-test for you. Do you often find yourself needing to sit down or steady yourself against a table when putting on your shoes or stepping into pants? Do you increasingly need to use the armrests of your chair to “push off” when getting up? Do you generally hold on to handrails whenever you go up and down stairs? If you stand with your feet close together, do you feel unsteady and unable to balance yourself properly?
If you’ve answered “Yes” to any of these questions, you might want to start giving a little bit of thought to your sense of balance, and how important it is to you. It’s easy to take good balance for granted—most people don’t give it a first or second thought until after they’ve experienced a fall. However, the behaviors we asked about in our self-test are actually “early warning signs” that your sense of balance may be starting to deteriorate. Your balance is controlled by an area of the brain called the cerebellum, which works in coordination with your vestibular (inner ear) system, your visual system (your eyes, and their ability to perceive whether you are standing upright), and your proprioceptive system (your body’s sense of position in space).
All of these systems begin to deteriorate once you pass the age of 40, as do the muscles they control. Worse still, this process of deterioration can become accelerated if you lead a sedentary lifestyle (which growing numbers of Americans do). And although you might not think of balance as a health issue, falling is the leading cause of injury for people over the age of 65. In the U.S., someone from this age group is treated in an emergency room for injuries resulting from a fall every 17 seconds.
So how do you improve your sense of balance, and protect yourself from dangerous falls? Simple—use it! Balance is to some extent a learned skill, so if you practice a few simple exercises that isolate these components of balance, you can actually make your sense of balance better. Experts on aging suggest performing a few exercises to improve your balance each day, starting in middle age, before the systems that control your balance have begun to deteriorate.
For example, just avoiding the use of handrails on stairs or the poles in buses and subway cars forces your body to work harder to maintain its balance, improving reflexes, increasing coordination and strengthening your muscles. Other exercises you can perform include creating an unstable surface at home (such as a board placed on wobbly pillows) and then practicing standing on it with one foot, or improving your coordination by standing on one leg with the opposite arm extended and then swinging the other leg back and forth. Office workers can improve their balance—and get a refreshing break at the same time—by practicing getting up from their chairs ten times in a row without using their hands. Each of these simple movements shifts your center of gravity, causes your muscles to react to changing positions, and improves your balance.
Just walking in a small circle around your living room or your backyard can be good for your balance, because walking along a curve is more difficult than walking in a straight line. When you’re out for a walk, try to choose uneven surfaces rather than smooth pavement because this also exercises the muscles in your back and legs that are essential for good balance. Or place cones or other objects in a line on the floor in front of you and then weave between them while walking. You can strengthen your hips, which are very important for balance, by holding on to a table or a kitchen counter and then swinging one leg forward, to the side, to the back, and then up to your chest with your knee bent. Do this ten times, and then switch to the other leg and repeat. Yoga, Tai Chi, martial arts, and other forms of exercise that emphasize flexibility can also improve your balance.
So if you are concerned about protecting yourself against falls as you age, the important thing to bear in mind is the phrase “use it while you’re young, or you’ll lose it as you age.” The more healthy exercise you get in your 30s and 40s, the more healthy – and safe – you’ll be in your 60s and beyond.
Good posture isn’t exactly a high priority for many Americans. For millions of us, the number-one priority is working to provide for our families—and sitting all day at a desk is how we achieve that. However, poor posture while sitting at work for many hours every day can actually lead to poor posture while standing the rest of the time—and that’s a more serious problem than one might think.
A Wall Street Journal article entitled “How Bad Sitting Posture at Work Leads to Bad Standing Posture All the Time” talks at length about this phenomenon. Allston Stubbs, an orthopedic surgeon at Wake Forest Baptist Medical Center who treats patients with back or joint pain, puts it this way: “[Posture] is probably the 800-pound gorilla when it comes to health and wellness… We see the spine and overall skeletal structure being critical to a patient’s functionality and their satisfaction with their life and health care.”
This means that many Americans’ habit of sitting all day with no thought to their posture has severe consequences—without good posture, many people can develop serious neck, shoulder, and back pain, leading to a sharp decline in their quality of life. Sitting all day with poor posture can lead to muscular back pain, herniated discs, and even pinched back nerves.
Poor sitting posture can also cause tension headaches, diminished breathing, and fatigue. It can even make you look older, according to the LA Sentinel. “Never underestimate the beauty and health benefits of good posture. Often poor posture is just a bad habit that is easily corrected. Poor posture not only makes you look older, but could be the first step toward dowager’s hump, double chin, potbelly, and swayback as well as some internal problems too. When a person is hunched over or not standing straight, that person may be perceived as older than they actually are. Good posture is not only beneficial to your body; it also makes you look taller and slimmer. What’s more, good posture can convey self-confidence, which may just be the best accessory you can have.”
Additionally, good posture is essential for a healthy spine. It can reduce or eliminate back (and shoulder and neck) pain, and it can even improve your mood.
However, there are millions of people today who simply have not learned what good posture is—and it’s not standing rigid, with shoulders thrown back, as many may have learned in childhood. Rather, as the WSJ articles says, “Good posture doesn’t just mean standing with the shoulders thrown back. More important is maintaining good alignment, with ears over the shoulders, shoulders over hips, and hips over the knees and ankles. Body weight should be distributed evenly between the feet.”
While workplace-related posture problems are getting a lot of attention in the media these days, the importance of good sitting posture to office workers’ health is hardly news to the U.S. government. The United States’ Occupational Safety & Health Administration (OSHA) offers a number of tips for good sitting posture, including keeping your head in line with your torso as well as keeping your elbows close to your body and your thighs and hips parallel to the floor. OSHA also recommends using a well-padded seat, keeping your shoulders relaxed, and making sure your forearms, wrists and hands are straight and well-aligned.
One of the most effective ways to get and keep getting physical exercise is to make it an enjoyable job. While raking leaves may not be at the top of your list of fun tasks, that attitude can change with a few tips. Fall is here, and for many people, that means lots of leaves in the yard. They aren’t going to rake themselves—so why not make this seemingly dull chore into a fun, healthy workout? Here are a few tips that can make raking leaves into a workout you can be proud of.
For a child, falling down is almost inevitable and generally doesn’t result in a trip to the emergency room. However, even minor falls can sometimes cause serious injuries. If you hear a cracking sound or if your child has bruising, swelling, or a limb deformity, there’s a chance your child may have broken a bone and you should seek medical attention right away if you notice these symptoms. Most types of breaks are routine (for the medical staff if not for the parent), but those involving a growth plate can present complications and require extra attention.
There is a marked difference between the bones of an adult and those of a child. Children have what are called physes—that is, growth plates. These growth plates are located at the end of long bones in the arms and legs. The growth plates, made of soft, rubbery cartilage, cause the bone to grow in length. Growth plates are found near the shoulder joint, elbow joint, hip joint, knee joint, ankle joint and wrist joint. Of the six main locations the ankles and wrists are particularly vulnerable to harm.
Growth plate damage can lead to long term problems. When a growth plate is injured, the bone may stop or slow growing. This is why it is essential to seek qualified medical treatment immediately to avoid problems later in life. If injured, a child should under no circumstances “walk it off.”
It is imperative to get the child to a doctor as soon as possible if you suspect a growth plate break. Growth plates heal quite rapidly, which gives doctors only a very short window to do non- surgical manipulations in order to set broken bones correctly. If your child has a minor, non-displaced break, the doctor may treat it like a sprain and recommend a splint, cast, or walking boot to protect the area for four to six weeks. Usually, these types of fractures do not require long-term care. Preferably, a growth plate fracture should be set within a week of injury.
When a child’s bone has moved or been displaced, an orthopedist can set the bone back in place in the emergency room without the need to operate. The child will be anaesthetized in the emergency department, and the doctor will use X-rays to determine where to correctly move the bone. Once the bone has been set, the doctor will set a cast in order to keep the bone in place. Usually the child will be allowed to go home that night, but occasionally they will be admitted to ensure the swelling is not too severe. Proper care and follow up will likely involve physical therapy and doctor’s visits for the next half a year.
Most growth plate fractures heal properly and do not result in any long-term issues. Once in a while, the bone stops growing and winds up shorter than the other appendage. For example, a fractured leg might become shorter than the opposite leg. Early detection that growth is unequal between the two limbs is essential. However, this is a true minority of cases and most children heal just fine.
Medical science has given the healthcare community the knowledge and tools to extend life in ways that would have seemed like science fiction a generation ago. But, believe it or not, these modern miracles also pose a challenge—the possibility of life without quality of life. In other words, living longer but not necessarily living better.
With this in mind, it’s becoming more important than ever to do what you can while you’re still relatively young to “grow old gracefully” later on. So how do we put together a “playbook” for safeguarding our lifestyle as we age? One approach is to look into the midlife habits of those who live into their 70s, 80s and beyond while retaining both their physical and mental health to see what we can learn from them.
When you examine the research studies and first-person accounts of healthy seniors, there’s one lesson that’s particularly striking: “Use it or lose it.” And this lesson seems to apply equally to both our mental and physical abilities. According to many experts, the pillars of a healthy lifestyle include (in order) regular exercise, a healthy diet, mental stimulation, good quality sleep, successful stress management, and maintaining an active social life.
Why it’s as important to exercise your mind as it is your body
The third “pillar” in this list surprises some people, though it really shouldn’t. Studies on the prevention of Alzheimer’s disease and other cognitive impairments indicate that seniors who regularly read and complete crossword puzzles are far less likely to develop Alzheimer’s than those who don’t. One of the reasons, these scientists speculate, is that the neural connections that are “first to go” when brains begin to deteriorate with age are those associated primarily with words. Thus people may tend to forget people’s names, or the names of places, or have trouble finding “the right word” for things. Engaging in activities that continually forge new connections between words and concepts in our minds has been proven to prevent and in some cases even reverse the ravages of dementia.
One study, known as ACTIVE (the Advanced Cognitive Training for Independent and Vital Elderly study) tested nearly 3,000 adults over 65 and found that the three most valuable “brain exercises” that staved off degeneration were activities that improved 1) your memory, 2) your reasoning abilities, and 3) the speed at which you process information. Those participants in the study who participated in activities to strengthen these areas showed improvements that lasted for at least five years, and translated into real-life improvements such as being able to manage their money and households.
When it comes to choosing the “best” activities for keeping your brain active, there’s still no general consensus. While it’s still an open question, some researchers recommend word games (like crossword puzzles or Scrabble) or learning a new language. Others suggest memorization exercises. Still others believe that strategy games, riddles, or puzzles will have the greatest benefit because they encourage you to “think in new ways.” Modern video and computer games may also be helpful in stretching your brain and keeping it active. You can find other resources on the Internet – “brain gyms” that provide all of these things, such as Luminosity, Brain Food or MyBrainTrainer. Some of these websites may cost money or charge a membership fee, but if what you’re looking for is to keep your brain healthy and active for the rest of your life (and you enjoy the activities they offer), it may be well worth it. In the meantime, there are still many, many options available even if you’re on a tight budget. Public libraries are a particularly great resource! As with physical exercise, the thing that makes mental exercise “work” is how often you do it, not what you pay for it.
For many running enthusiasts, it is essential to keep improving the workout technique and to keep things interesting. One way of doing this is it to try out different surfaces such as the treadmill, the street, and the track. However, new information is coming to light about the best way to upgrade your running routine: running cross-country on a trail. Why is trail running so beneficial for runners?
For trail running beginners, it is important to follow some basic tips, such as:
There is no question that football is a full-contact sport that has the potential to cause a variety of injuries, some of which can be very serious. There is also no question that tackles are the most dangerous part of the game. Concussions and other head injuries, plus damage to the neck and spine can not only put a player out of commission, they may also lead to permanent injury or death.
Today’s professional football players are large, strong and fast. The traditional wraparound tackle places the head into harm’s way and increases the risk of injury. Football officials are promoting a method to change all this. To prevent or lessen this danger, the objective is to take the head out of play as much as possible. This is called the “heads-up” method of tackle. The experts say that you should not lead with your head down, as this can be dangerous not only for the tackler but also for the ball carrier.
Why has this become such an issue? The Washington Post reported in early 2013 that professional football injuries have risen between 2000 and 2011 from 2,640 to 4,473 injuries. In that same period, the average number of weeks a player spends on the NFL injury report has grown from 3.24 to 4.12 weeks. So, there are not only more injuries across the board, but longer lasting injuries as well.
The method recommended by professional football officials, including the NFL commissioner, and even the CDC, involves a specific form of stance and approach. With the head up and back, the chest forward and the arms extended slightly with elbows pointed down and knuckles pointed up, the tackler uses their leg muscles and hips to lunge upward, driving the chest and shoulders into the ball carrier. The tackler ends by throwing what looks like double uppercuts.
But not everyone agrees that the technique promoted by football officials is practical or that it’s likely to reduce the game’s inherent risks in any meaningful way. Matt Chaney, an analyst of football health issues, including catastrophic injuries, wrote a scathing critique of the method in a 2012 issue of Slate magazine. Chaney wrote, “As a former head-basher in NCAA football, I can say that this is a technique that I’ve seen precisely no one, ever, use on the field.” So, even though coaches may train and drill the technique, according to Matt Chaney, it isn’t used in the real world. Chaney explains, “To ask the body, while traveling at [football] speed, to crane the neck up and back, in defiance of physics, is a fool’s errand.”
At the same time, however, it is clear that some approaches to tackling—and being tackled—are safer than others. And the incentives to reduce serious injuries are beginning to grow for everyone in the broader football community, from team owners and coaches to the players themselves. Rule changes, improvements in protective gear and—yes—advances in tackling techniques all have a role to play. This is especially true in youth football programs.
Professional football players take their chances. After all, it’s part of their chosen career. However, juvenile players require more care and guidance. So what can be done to protect youth players? While some believe that better education and training (as well as better equipment) is the answer, others think that the nature of tackle football itself is the problem. Unlike baseball, which is sometimes described as men playing a boys’ game, tackle football is in some respects a man’s game being played by boys. This is the perspective taken by Matt Chaney. “If the NFL is truly serious about protecting kids,” wrote Chaney, “instead of building up the sport’s talent pool, then the league and the players’ union should start listening to the growing medical call to end tackle football for pre-adolescents.”
Each of the 206 bones in your body is constantly undergoing a process of breakdown and renewal, even if you have never suffered a broken bone in your life. Your entire skeleton is completely replaced approximately every 10 years. The construction of bone tissue begins when we are a fetus in the womb, and continues until we die. Our genetics and both the nutrients we receive before we are born and those we get through our diet in our youth have a major influence on the strength and endurance of our skeletal system.
Fetal cartilage is the precursor to bone growth, and is transformed into bone in a process called ossification. The fetal cartilage attracts the minerals calcium and phosphorus, which cover the cartilage cells. The fetal cartilage cells soon die off, leaving small holes through which blood vessels can grow. Osteoblasts, the specialized cells responsible for bone growth, travel to the developing bone via these tiny blood vessels. There they produce the collagen fibers that are the structure over which bone is formed, and attract the calcium with which the fibers are covered. Osteoblasts eventually transform into osteocytes, which become part of the calcium mix that helps to reinforce the collagen fibers and strengthen the bone.
Osteoclasts are the cells responsible for breaking down and removing old bone tissue, leaving small chambers that allow marrow to form. The small holes osteoclasts create are why this particular part of the bone is called spongy bone. Although it is hard, spongy bone resembles a common kitchen sponge. In our youth, the osteoblasts outnumber the osteoclasts, so we have a net gain of bone growth. This is when the growth of bone is referred to as modeling. Bone continues to grow until approximately our mid-20s, at which point we have reached our greatest bone density.
From our mid-20s on, our bones are in a constant process of remodeling. At this point, the osteoblasts can no longer keep up with the osteoclasts. While bone is continually being rebuilt, no supplemental bone is being added, so we can begin to lose bone density. Even though our bodies no longer add to our stock of spongy bone tissue after our mid-20s, we can still continue to add bone to the outer layer of our bones, called compact bone. Compact bone accounts for about 80 percent of our bone mass and protects the more fragile spongy bone inside. Although compact bone is considerably denser than spongy bone, it still has tiny channels for blood vessels and nerves to pass through.
Our spongy bone is filled with two types of marrow, red and yellow. Red bone marrow is responsible for the creation of our red and white blood cells and the platelets that are necessary for clotting in order to stop bleeding when we are injured. Yellow bone marrow consists mostly of fat cells and is more common in our long bones, such as the femur.
A healthy diet with adequate amounts of calcium, magnesium, phosphorus and vitamin K, along with a little regular weight-bearing exercise, will help ensure that you maintain the greatest bone density possible as you age, and will help protect against the danger of fractures due to osteoporosis.