Duct tape cured my Plantar Fasciitis. As weird as that may sound, it's true.
At age 50, I'd never even heard of Plantar Fasciitis (pronounced
PLAN-TAR FA-CEE-EYE-TIS), but it was about to make my life a living
hell.
My entire working life has been spent walking on concrete.
When I was young, I never gave that any serious consideration, even
though the "old people" told me I should take care of my feet, stand on
mats, wear good shoes.
About 5 years ago, my feet started giving
me trouble. They hurt, and I mean really hurt. When my feet hit the
floor in the morning, they felt like they were on fire. I could hardly
stand up. I'd hobble down the stairs and by the time I got to the
kitchen, the pain would have lessened somewhat.
I'd go to work
and be in pain all day. Most days, by the time I got home, I'd be in
tears. The relief of getting my shoes off was almost climaxing. I'd go
all evening with pain, but not the excruciating pain of my work day.
Then it would start all over again the next day.
The pain moved
around, too. Some days there would be a sharp, constant pain in the
center of my heel. Other days the pain in my heel would be on the side.
Some days, it would be my arch that hurt. Some days it would be the
whole bottom of my foot and up into my calf.
Now, let me say
that I am not one to run to a doctor. I always assume that whatever it
is will go away on its own and if it doesn't, then I will go to a
doctor. This didn't go away, so I went to my family physician. When he
found out that I had been walking on concrete for all those years, he
told me that that will cause you to have bad feet in later years and it
was just something I would have to live with. He told me to get
cushioned inserts.
Well! He wasn't any help at all. I could have
saved my money, because, like him, I really believed that this was just
a condition of getting older and something I would just have to live
with the best that I could.
During the next two years, I tried
every single insert, insole, arch support, and heal protector I could
find. I even sent away for $200 inserts molded to fit my feet. I found
that every insert hurt my feet even more. It seemed to me that the
inserts were pushing up on my arch and it felt like I needed the arch
held up without pressure being put on it by being pushed up.
So, I did what any red blooded American does in any emergency situation.
I got out the duct tape!
One morning, after I put on my socks, I wrapped a piece of duct tape
around my foot , not so tight as to cut off circulation, just tight
enough to hold my arch up so it couldn't sag.
Off to work I
went. Oh, the glory! I was in heaven. The pain wasn't entirely gone, but
it was lessened so much that I felt I had finally found what I needed.
Everyone at work, used to seeing me hobbling around, asked how my feet
were because it was obvious that I was walking normally again.
I
told everyone about my duct tape solution. They thought I was weird,
but then they think I'm pretty weird to begin with, so no big deal.
A few months after that, I went to a new doctor for an initial exam,
due to a change in insurance. When she saw the duct tape around my feet,
she asked about it , so I explained that it was my solution to fallen
arches or whatever it was that was wrong with my feet. She had me remove
the tape and my socks and proceeded to push and prod as she asked
questions.
She then told me that my problem is called Plantar
Fasciitis. She explained that Plantar Fasciitis can have many causes,
sometimes it is a trauma to the foot, sometimes stress from the wrong
shoes all your life, sometimes from walking on concrete for years. Since
I could remember no trauma to my feet that could have started it and
because it was in both feet, she thought that my Plantar Fasciitis was
due to concrete walking for 30 odd years.
She told me that the
ligament that runs along the bottom of the foot ( the plantar) gets
inflamed because it is worn from years of abuse and can't take the
pressure anymore which causes the pain.
I had told her that I
had also discovered that in addition to the duct tape, at night, if I
laid on my stomach and tucked my feet down between the mattress and the
foot of the bed so that my feet were at a 90degree angle and my calf
muscles were stretched, it helped me to not have so much pain when I got
out of bed. She said I was very ingenious to have figured this all out
on my own. I am nothing if not resourceful.
She told me to come back in one month and in the mean time,
1. I was to take an Alieve in the morning and one at night to get rid of the inflammation.
2. A couple times a day, I was to do 5 or 10 calf stretches which
consisted of standing on any raised platform, preferably a stair step
where I had a rail to hold on to, and, with the ball of my foot on the
platform, gently lower my heels till I could feel the calf muscle
stretch.
3. In the evening, I was to sit, bring my foot up onto
my knee, hold my toes and gently pull them back till I could feel the
stretch and hold the position for 15 seconds, repeat 5 times. Then lower
my foot onto a frozen can of orange juice placed on the floor and roll
it back and forth under my arch for at least 5 minutes.
4. She
said to continue tucking my feet between the mattress and foot of the
bed and wear the duct tape, or buy an elastic band in the foot section
at any drug store. I did buy the elastic band, but it was too tight, so I
continued with the duct tape which I could adjust .
5. And lastly, I was to change my shoes at lunch time every day.
After a month, when I made my return visit, I hugged her! Then I
showed her my duct tape -less socks! My feet were back to normal! My
Plantar Fasciitis had been brought to heel!!
After more than 2
years of agonizing pain, hundreds of dollars spent on inserts, and more
tears shed that I even want to remember, suddenly I could get up in the
morning with no pain, walk all day with no pain, spend the evening with
no pain, sleep through the night with no pain! It was wonderful!
In the three years since then, occasionally, I will have a flare up,
usually if I have to pull a double shift. But now that I know its
plantar fasciitis, I stop it at the first twinge by doing the routine of
duct tape, Alieve, stretches, frozen orange juice, tucking and changing
shoes. In two days, my feet are fine again. Not being a doctor, I
don't, of course, guarantee this will work for everyone who has, or
suspects they have, plantar fascittis. All I know is…. It worked for me!
I still have to only wear good shoes that have good arch support in
them, I never wear the same pair of shoes two days in a row and I will
never again wear high heels, but it is a small price to pay for pain
free feet.
Monday 4 August 2014
The BMI ( Indicator Of Heart Disease Risk ) is Wrong
After years of throwing terms around like "overweight", "obese", and
"morbidly obese", doctors are conceding that the BMI where they derived
those terms might actually be wrong. The BMI (Body Mass Index) has been
around for almost 100 years, but since 1998, the BMI has been the gold
standard that doctors and the government use to determine whether or not
a person was fat. To calculate BMI, you divide your weight by the
square of your height. For those of us who are not math majors, several
websites and charts hanging in our doctors' offices are happy to tell us
if we are overweight or obese. For instance, my sister who is 5'9" and a
nice, trim, compact 170 pounds is considered overweight.
But new research put out by the Mayo Clinic indicates that the BMI might not be the best indicator for obesity after all. An athletic, muscular man who is 5'10" and 200 pounds comes up "overweight" on the BMI scale because of his muscle mass. Muscle weighs more than fat, so simply using height and weight is not an accurate measure of a person's fitness. BMIs that indicate a person is overweight (25-29) or obese (29 and up) can affect a person's health and life insurance status erroneously.
For years, it has been assumed that those indicated as "overweight" according to the BMI were at a much higher risk of dying from heart related conditions. But the new research that the Mayo Clinic in Rochester, Minnesota, published indicates something quite different. In their study of 250,000 people with heart disease, those with a BMI that indicated overweight status had less chance of dying from heart problems than those with a normal BMI. And people with a normal BMI were less likely to die than people with low BMI. And as expected, severely obese people did have a higher incidence of death from heart-related disease.
The difference in the overweight group is likely to be muscle. People with more muscle are more fit and healthy, but that muscle puts them in the overweight group for their height. Numbers that get tossed around frequently are that 60% of Americans are overweight and half of those are obese. These numbers are based strictly off the BMI, and the group of overweight Americans is likely to be much lower.
But before we all breathe a sigh of relief and down a cheeseburger, bag of potato chips, and a carton of moose tracks ice cream (yum), the study leader did say that the research did not prove that obesity was harmless. Being overweight or obese still carries an increased risk of heart disease, diabetes and certain types of cancers.
So how do we measure the risks? According to experts in the heart health field, the risk of heart disease can be calculated by measuring your waistline. Or even better, by a hip/waistline ratio. (I know, those were two things I never wanted to measure again either). That is because the fat in your abdomen is dangerous fat. Fat packed around the organs in the abdomen is more metabolically active, which means it releases more of the acids that increase heart disease risk and other conditions like high blood pressure and high blood sugar.
To calculate the waist-to-hip ratio (to keep an acronym it's called the WTHR), measure both your waist and hips, and divide the waist size by the hip size. And yes, this indicator realizes the difference between men and women, unlike the BMI. For women, the ratio should be no more than 0.8. In other words, your waist should be smaller than your hips. And for men, it should be 1.0 or less. That means that a man's waist should be the same measurement as his hips or smaller. The beer-and-pizza belly has to go!
And that's where I realize that I need to exercise a bit more and eat better foods. I always coast along at my nice BMI of about 22. But the new WTHR indicator doesn't look so nice. And there is one formula that never fails: eat less than you use. That will take care of BMI, WTHR and any new fat indicators just showing up.
But new research put out by the Mayo Clinic indicates that the BMI might not be the best indicator for obesity after all. An athletic, muscular man who is 5'10" and 200 pounds comes up "overweight" on the BMI scale because of his muscle mass. Muscle weighs more than fat, so simply using height and weight is not an accurate measure of a person's fitness. BMIs that indicate a person is overweight (25-29) or obese (29 and up) can affect a person's health and life insurance status erroneously.
For years, it has been assumed that those indicated as "overweight" according to the BMI were at a much higher risk of dying from heart related conditions. But the new research that the Mayo Clinic in Rochester, Minnesota, published indicates something quite different. In their study of 250,000 people with heart disease, those with a BMI that indicated overweight status had less chance of dying from heart problems than those with a normal BMI. And people with a normal BMI were less likely to die than people with low BMI. And as expected, severely obese people did have a higher incidence of death from heart-related disease.
The difference in the overweight group is likely to be muscle. People with more muscle are more fit and healthy, but that muscle puts them in the overweight group for their height. Numbers that get tossed around frequently are that 60% of Americans are overweight and half of those are obese. These numbers are based strictly off the BMI, and the group of overweight Americans is likely to be much lower.
But before we all breathe a sigh of relief and down a cheeseburger, bag of potato chips, and a carton of moose tracks ice cream (yum), the study leader did say that the research did not prove that obesity was harmless. Being overweight or obese still carries an increased risk of heart disease, diabetes and certain types of cancers.
So how do we measure the risks? According to experts in the heart health field, the risk of heart disease can be calculated by measuring your waistline. Or even better, by a hip/waistline ratio. (I know, those were two things I never wanted to measure again either). That is because the fat in your abdomen is dangerous fat. Fat packed around the organs in the abdomen is more metabolically active, which means it releases more of the acids that increase heart disease risk and other conditions like high blood pressure and high blood sugar.
To calculate the waist-to-hip ratio (to keep an acronym it's called the WTHR), measure both your waist and hips, and divide the waist size by the hip size. And yes, this indicator realizes the difference between men and women, unlike the BMI. For women, the ratio should be no more than 0.8. In other words, your waist should be smaller than your hips. And for men, it should be 1.0 or less. That means that a man's waist should be the same measurement as his hips or smaller. The beer-and-pizza belly has to go!
And that's where I realize that I need to exercise a bit more and eat better foods. I always coast along at my nice BMI of about 22. But the new WTHR indicator doesn't look so nice. And there is one formula that never fails: eat less than you use. That will take care of BMI, WTHR and any new fat indicators just showing up.
5 Essential Back Care Tips
Most people, at some time in their life will experience some kind of
back pain. For some, that back pain may have been caused by a known
injury. For others, the source of the back pain may be unknown. Either
type of back pain may also be recurring, or chronic. There are some easy
and natural ways to help alleviate any type of back pain.
1. A Good Mattress is absolutely essential to diminishing and alleviating back pain. The type of mattress you buy, is a matter of preference. It does not matter if you purchase a spring-box mattress or a memory foam mattress. The key to a good mattress for your back is one that offers enough firmness to support the back during sleep. If you have chronic back pain or recurring back pain, select a mattress that is slightly firmer than you may otherwise purchase.
2. Sleep on your Back. Although the pain may originate in your back, sleeping on your back is the best and most effective way to maintain a balance during sleep. If you sleep on your stomach, the spine has no support.
When you sleep without supporting your back, and you have chronic or recurring back pain, you may wake up and be hunched over or feel numbness in your lower back. Similarly, sleeping half on your stomach with one leg bent can also cause the same back problems. Side sleeping is acceptable for those with chronic back pain if you sleep with a pillow support between your knees.
3. Exercise Regularly. You may think the last thing you can do with chronic back pain or recurring back pain is exercise. However, unless your doctor has forbade you from exercising, you can and should exercise even if you suffer from back pain. Find a low-impact exercise that you enjoy.
4. Maintain Good Posture. Nothing is worse for chronic back pain or recurring back pain than slouching. If you slouch at work or anywhere else, sit up. If you need to use a back pillow as a support between your back and the chair, then do so. Also, when you stand, stand tall and straight, lengthening the spine and not putting undo stress on either side of the body.
5. Use Ergonimic Furniture. For proper back care it is necccessary to use ergonimic furniture at home and at work. When working at a desk or at a computer, your feet should be touching the ground and your thighs should be parallel to the ground. When thihgs are tilted in either direction, it can cause strain on your back. Your back will benefit from using a chair which provides firm back support.
With these basic tips you will hopefully alleviate some of the recurring back pain and help diminish the severity of chronic back pain.
1. A Good Mattress is absolutely essential to diminishing and alleviating back pain. The type of mattress you buy, is a matter of preference. It does not matter if you purchase a spring-box mattress or a memory foam mattress. The key to a good mattress for your back is one that offers enough firmness to support the back during sleep. If you have chronic back pain or recurring back pain, select a mattress that is slightly firmer than you may otherwise purchase.
2. Sleep on your Back. Although the pain may originate in your back, sleeping on your back is the best and most effective way to maintain a balance during sleep. If you sleep on your stomach, the spine has no support.
When you sleep without supporting your back, and you have chronic or recurring back pain, you may wake up and be hunched over or feel numbness in your lower back. Similarly, sleeping half on your stomach with one leg bent can also cause the same back problems. Side sleeping is acceptable for those with chronic back pain if you sleep with a pillow support between your knees.
3. Exercise Regularly. You may think the last thing you can do with chronic back pain or recurring back pain is exercise. However, unless your doctor has forbade you from exercising, you can and should exercise even if you suffer from back pain. Find a low-impact exercise that you enjoy.
4. Maintain Good Posture. Nothing is worse for chronic back pain or recurring back pain than slouching. If you slouch at work or anywhere else, sit up. If you need to use a back pillow as a support between your back and the chair, then do so. Also, when you stand, stand tall and straight, lengthening the spine and not putting undo stress on either side of the body.
5. Use Ergonimic Furniture. For proper back care it is necccessary to use ergonimic furniture at home and at work. When working at a desk or at a computer, your feet should be touching the ground and your thighs should be parallel to the ground. When thihgs are tilted in either direction, it can cause strain on your back. Your back will benefit from using a chair which provides firm back support.
With these basic tips you will hopefully alleviate some of the recurring back pain and help diminish the severity of chronic back pain.
Work Out with Exercise Bands
Exercise is recommended for lots of reasons: to lose weight; to prevent
weight gain; to gain muscle; to improve balance and coordination; to
reduce stress and improve mood; to lower insulin levels; to lower blood
pressure and triglycerides; and even to sleep better. But it's hard for
some of us to fit in a daily exercise routine. We lead busy lives, and
in those few precious hours between work and sleep, we'd rather talk to a
friend or watch "Gray's Anatomy" rather than do a workout.
Band exercising can be done almost anywhere. It is easy to do and beginners, people who have joint or muscle pain, those who are overweight and find it difficult to exercise, or even a fit person who needs a light workout for awhile will find exercising with bands beneficial. This type of exercise uses resistance. Basically you use a group of muscles to stretch a big rubber band in a controlled, repetitive fashion. Other resistance bands are made from rubber tubing, and called exercise tubes, but the workout is the same.
Initially, exercise bands were used by physical therapists to assist clients in regaining strength after surgery or an injury but they can be used to perform the same kinds of resistance training as using free weights or weight machines.Sometimes people who are used to other types of strength training feel that they won't get a real workout with exercise bands. There are some differences between using free weights and the exercise bands.
The resistance does feel different when using the bands. When you use a free weight, gravity assists you in the motion, so the resistance is stronger during one part of the exercise. An example of stronger resistance would be the upswing of a bicep curl when using a free weight. With an exercise band, the tension should be constant throughout the movement.
You can easily "cheat" when using the resistance bands because you are in control of the tension. You can shorten or lengthen the band to make the movement or exercise easier. But the muscle is still getting a workout. Sometimes, the exercise bands can challenge the muscle even more than a free weight because the resistance is created from all sides.
It can be confusing to know exactly how to use exercise bands. You just need to know where to position the band to work the muscle group you need. For instance, you can wrap the band around your back and grab the two ends for a chest press. You can stand on the exercise band and grab the handles for a bicep curl. You can attach an exercise band to a door to do lat pulldowns or tricep pushdowns.
You can buy exercise bands or tubing at almost any sporting goods store. You can buy them at department stores like Sears, Wal-mart, or Target. It is a good idea to buy a set of bands to have a variety of resistance. It gives you a goal to work toward: as each band exercise becomes easy, you can graduate to a heavier band.
If you decide to use exercise bands, as with any physical activity, check with your doctor first. Then, as with any exercise, start by warming up your muscle groups by jogging or walking in place before starting. Maintain good posture. Keep your wrists straight, since pulling on the exercise bands is what creates the resistance. Breathe normally; don't hold your breath. Use controlled movements; the controlled, continuous resistance of the exercise bands is what works your muscles.
The exercises should feel challenging but not painful. If anything hurts, stop. Try a different exercise or a lighter band. Most experts recommend doing 8-12 repetitions of each exercise, and 2-3 sets of repetitions every other day. Some people do the upper body movements with the exercise bands on one day, and concentrate on the lower body the next day. If you are just starting out, doing one set of repetitions each day might be helpful.
Using exercise bands is easy, cheap, portable, fun, and yes, it does work! In just a week or two, you will really notice a difference in your muscles and the way your body moves. In four weeks, you should be able to see more musculature if you continue using the exercise bands.
Band exercising can be done almost anywhere. It is easy to do and beginners, people who have joint or muscle pain, those who are overweight and find it difficult to exercise, or even a fit person who needs a light workout for awhile will find exercising with bands beneficial. This type of exercise uses resistance. Basically you use a group of muscles to stretch a big rubber band in a controlled, repetitive fashion. Other resistance bands are made from rubber tubing, and called exercise tubes, but the workout is the same.
Initially, exercise bands were used by physical therapists to assist clients in regaining strength after surgery or an injury but they can be used to perform the same kinds of resistance training as using free weights or weight machines.Sometimes people who are used to other types of strength training feel that they won't get a real workout with exercise bands. There are some differences between using free weights and the exercise bands.
The resistance does feel different when using the bands. When you use a free weight, gravity assists you in the motion, so the resistance is stronger during one part of the exercise. An example of stronger resistance would be the upswing of a bicep curl when using a free weight. With an exercise band, the tension should be constant throughout the movement.
You can easily "cheat" when using the resistance bands because you are in control of the tension. You can shorten or lengthen the band to make the movement or exercise easier. But the muscle is still getting a workout. Sometimes, the exercise bands can challenge the muscle even more than a free weight because the resistance is created from all sides.
It can be confusing to know exactly how to use exercise bands. You just need to know where to position the band to work the muscle group you need. For instance, you can wrap the band around your back and grab the two ends for a chest press. You can stand on the exercise band and grab the handles for a bicep curl. You can attach an exercise band to a door to do lat pulldowns or tricep pushdowns.
You can buy exercise bands or tubing at almost any sporting goods store. You can buy them at department stores like Sears, Wal-mart, or Target. It is a good idea to buy a set of bands to have a variety of resistance. It gives you a goal to work toward: as each band exercise becomes easy, you can graduate to a heavier band.
If you decide to use exercise bands, as with any physical activity, check with your doctor first. Then, as with any exercise, start by warming up your muscle groups by jogging or walking in place before starting. Maintain good posture. Keep your wrists straight, since pulling on the exercise bands is what creates the resistance. Breathe normally; don't hold your breath. Use controlled movements; the controlled, continuous resistance of the exercise bands is what works your muscles.
The exercises should feel challenging but not painful. If anything hurts, stop. Try a different exercise or a lighter band. Most experts recommend doing 8-12 repetitions of each exercise, and 2-3 sets of repetitions every other day. Some people do the upper body movements with the exercise bands on one day, and concentrate on the lower body the next day. If you are just starting out, doing one set of repetitions each day might be helpful.
Using exercise bands is easy, cheap, portable, fun, and yes, it does work! In just a week or two, you will really notice a difference in your muscles and the way your body moves. In four weeks, you should be able to see more musculature if you continue using the exercise bands.
Orthotics - Why Do You Need Them?
There was a time not too long ago where orthotics were thought of as the
exclusive domain of persons who suffered with painful joint conditions,
and found it difficult to walk.
Nowadays, anyone who has experienced the difference between specially formed support underneath their arches, and going "solo", prefers orthotics. Wearing orthotics is also recommended by foot specialists as a good way to alleviate back, neck, ankle and knee pain - as well as improve the wearability of footwear.
Today, a common problem is pronation-when the foot leans over to one side, causing wear-and-tear on the shoes, and on the foot. Another much-seen malaise of the feet is flat feet. Both conditions respond well to orthotics. The question is - which brand of orthotics one should opt for? A little research into the field yielded the following information on some leading manufacturers and providers of orthotics:
Aetrex
Aetrex, in sizes from 7M to 14 M, has five (5) models, ranging from their most athletic number, to their dressy style. The Full Length Sport has the maximum cushioning for top-notch absorbency of weight. The neutral heel cups and cushions. The arch support is gentle. The cost is around $60.00. The Aetrex Full Length Dress Leather doesn't offer as much support and looks a little thin, but seems perfect for golf or "dressy" shoes. It is durable. Also around $60.00.
The Aetrex Full Length with Metatarsal Support is more formidable, with its raised side, to relieve metatarsal (the five long bones of the foot.) Neutral heel cups and cushions, as does the Full Length Sport and the Full Length Dress Leather. It's $60.00. The ¾ Dress Length Dress does not restrict the toe area. It stops short of the toes, extending from the heel to the ball of the foot. It offers quality support for dressy shoes (like sandals) with a leather-look, for a great price. Just under $45.00. The Full Length Sport Posted is ideal for pronated feet. It is used for all footwear, but is excellent for sports shoes. This model offers maximum shock absorption and cushioning and a posted heel to realign the back portion of the foot. $60.00.
Walkfit
Walkfit claims to have conducted a scientific test which helped 90% of its participants reduce pain. It supports ligaments, tendons, muscles and bones. Realistically, most orthotics align your body-another claim made by Walkfit. What is impressive is Walkfit's Life-time replacement warranty. And rather than provide a separate model for dress shoes, the company provides sandal adaptors, which are adhesives that are applied to the device to keep it from slipping in open-toed shoes The orthotics is made of hard plastic. Men and women's sizes from 5 to 14 ½. $30.00 includes shipping and handling.
Foot Dynamics
Moving up to the other end of the price spectrum, Foot Dynamics has Sports Orthotics which are made for high-mileage and rough, athletic impact. This company sends an impression kit via Priority Mail. They require you to make a mold of your foot, and so don't provide sizes.
This company actually incorporates bounce-inducing cork in their Alpine and Running Orthotics' arch fill! The Running Orthotics are $160; the Alpine Ski Orthotics, $140.00. Borrowing from the old-school orthotics, these are semi-rigid, but more comfortable.
Foot Dynamics has a model for every sport - in addition to running. There's a Water Sports Orthotics (designed to be wet, with a nylon shell, for $150.00); a Cycling Orthotics (with a "floating" rear foot design for maximum ankle motion, for $140.00); a Skiing Orthotics (which increase power transfer to the ski edge, for $140.00-$150.00); and a Court Sport Orthotics (for cutting, jumping and quick starts, with HDC Foam for superior abrasion resistance, for $160.00.)
If golf is your game, "whether you walk or ride", says the Foot Dynamics website, the Golf Orthotics model, at $140.00, with rear foot stabilization and a melon shell, will improve your swing
Whichever sort of landing you your feet prefer-soft or hard-chances are one of the above-named Orthotics companies will meet your foot comfort and support needs.
Nowadays, anyone who has experienced the difference between specially formed support underneath their arches, and going "solo", prefers orthotics. Wearing orthotics is also recommended by foot specialists as a good way to alleviate back, neck, ankle and knee pain - as well as improve the wearability of footwear.
Today, a common problem is pronation-when the foot leans over to one side, causing wear-and-tear on the shoes, and on the foot. Another much-seen malaise of the feet is flat feet. Both conditions respond well to orthotics. The question is - which brand of orthotics one should opt for? A little research into the field yielded the following information on some leading manufacturers and providers of orthotics:
Aetrex
Aetrex, in sizes from 7M to 14 M, has five (5) models, ranging from their most athletic number, to their dressy style. The Full Length Sport has the maximum cushioning for top-notch absorbency of weight. The neutral heel cups and cushions. The arch support is gentle. The cost is around $60.00. The Aetrex Full Length Dress Leather doesn't offer as much support and looks a little thin, but seems perfect for golf or "dressy" shoes. It is durable. Also around $60.00.
The Aetrex Full Length with Metatarsal Support is more formidable, with its raised side, to relieve metatarsal (the five long bones of the foot.) Neutral heel cups and cushions, as does the Full Length Sport and the Full Length Dress Leather. It's $60.00. The ¾ Dress Length Dress does not restrict the toe area. It stops short of the toes, extending from the heel to the ball of the foot. It offers quality support for dressy shoes (like sandals) with a leather-look, for a great price. Just under $45.00. The Full Length Sport Posted is ideal for pronated feet. It is used for all footwear, but is excellent for sports shoes. This model offers maximum shock absorption and cushioning and a posted heel to realign the back portion of the foot. $60.00.
Walkfit
Walkfit claims to have conducted a scientific test which helped 90% of its participants reduce pain. It supports ligaments, tendons, muscles and bones. Realistically, most orthotics align your body-another claim made by Walkfit. What is impressive is Walkfit's Life-time replacement warranty. And rather than provide a separate model for dress shoes, the company provides sandal adaptors, which are adhesives that are applied to the device to keep it from slipping in open-toed shoes The orthotics is made of hard plastic. Men and women's sizes from 5 to 14 ½. $30.00 includes shipping and handling.
Foot Dynamics
Moving up to the other end of the price spectrum, Foot Dynamics has Sports Orthotics which are made for high-mileage and rough, athletic impact. This company sends an impression kit via Priority Mail. They require you to make a mold of your foot, and so don't provide sizes.
This company actually incorporates bounce-inducing cork in their Alpine and Running Orthotics' arch fill! The Running Orthotics are $160; the Alpine Ski Orthotics, $140.00. Borrowing from the old-school orthotics, these are semi-rigid, but more comfortable.
Foot Dynamics has a model for every sport - in addition to running. There's a Water Sports Orthotics (designed to be wet, with a nylon shell, for $150.00); a Cycling Orthotics (with a "floating" rear foot design for maximum ankle motion, for $140.00); a Skiing Orthotics (which increase power transfer to the ski edge, for $140.00-$150.00); and a Court Sport Orthotics (for cutting, jumping and quick starts, with HDC Foam for superior abrasion resistance, for $160.00.)
If golf is your game, "whether you walk or ride", says the Foot Dynamics website, the Golf Orthotics model, at $140.00, with rear foot stabilization and a melon shell, will improve your swing
Whichever sort of landing you your feet prefer-soft or hard-chances are one of the above-named Orthotics companies will meet your foot comfort and support needs.
The Dangers of and Damages Caused by Wearing High Heels
Why do we succumb to the expectations of society and wear shoes that
are do more damage than good all for the sake of impressing a
materialistic society? That's the question I began to ask myself after
years of torturous trials and tribulations with trendy footwear of the
heel variety. They are uncomfortable, expensive and damaging, but women
continue to wear them and I don't think it's because they feel good.
"Two bunions and some knee pain later", I have officially refused to
wear any shoes just for "fashion's sake (Well, with the exceptions of
weddings and funerals and only if the heal is 2 inches and less).
I've been the in the corporate world, but I first started out in a production job that allowed me to wear tennis shoes. Then I moved to a desk position, but I worked for a guy who was very laid back and didn't care what I had on my feet. Soon after I was promoted once again to work under a former "Miss Georgia." Needless to say, the wrath of the fashion police was about to come down upon me with a fiery vengeance.
My clothes were analyzed and some of them passed, but all of my shoes failed. She pulled items straight from her closet that were practically brand-new and soon, I was transformed and very uncomfortable. Trying to walk at work looked very much like a young child trying to walk on stilts-step, step, stumble-and wasn't a graceful site in the least. Some days I felt like I would never get to my desk. As soon as I did reach my cubicle, I would kick my shoes off and wiggle my toes that were screaming for oxygen and room.
My heels hurt and my arches felt like they were stretched beyond belief and were on the verge of snapping. Other parts of my legs hurt like my shins, knees, and thighs. I began to hate the shoes and secretly swore to burn them one day by dousing them first with kerosene and laughing before I lit the match. Then the scenario would be ruined by an interruption, "We have to go upstairs to for a meeting then we have to greet guests and escort them to the show." In my head I added, "Where we will stand for the next 60 minutes on over arched, too narrow of a foot bead, and outrageously tall heels of death. I can't wait."
When the shoe hand out stopped, I was released from the nest (with an observing eye) to buy my own pair of heels whether they were boots or sandals or any other type of style the beauty queen threw at me. Whatever they were, she would always say, "These are stylish and worth every penny." I remember when looking at the price tags, my eyes would widen and my feet would scream, "No, please don't put me in those things. I'll massage myself from now on…anything…just not those torture chambers." I could also hear my husband's voice, "You spent how much??? $70.00 on shoes that barely cover your feet….Whatttt!!"
To a lot of women, $70.00 for a sexy pair of heels is a steal as most pay $100.00 or more. That's not even getting into brands like Gucci or Prada. These prices reflect more towards Gianni Bini or a brand you can get at Dillards (which is where the shoe queen and I frequented). I quickly learned that all high heels were way overpriced and went to Payless without the shoe queen to find something more affordable but equally as damaging. Hey, if I was going to pay the price in the long run, might as well keep the front-end costs low so I could save up for the treatment expenses later.
Finally, I'd had enough of the shoe queen's demands and worked for a different company altogether. There I ran into the shoe nazi who paid $500.00 to $800.00 a pair for Prada and Gucci heels. I was able to touch a couple of them before shipping them off and they amazingly looked like some I saw at Payless for twelve bucks.
At the new company, I got to experience walking in heels on a concrete floor in a store colored like the MacDonald's playground. Then I started incorporating black tennis shoes with my black slacks and needless to say, I was left out of many publicity photos. Yet, we advertised "people can come in in their pajamas." I don't know about you, but I'd rather not see people who look like the fashion police when I'm in my PJ's.
Needless to say, I had enough of the fashionistas and drama queens, so I quit. The damage was done. My feet and legs, only 27 years of age, now feel haggard and older than they really are. Now I sit here with mysterious knee aches, varicose veins and two bunions that will need to be removed soon. The only shoes I can really fit into are these Crocs I picked up at the shoe store and amazingly enough, the right one is almost too narrow. I say "amazingly" because these shoes have been compared to actual boats, but hey they float. Doesn't everyone want a pair of floating shoes that are lightweight and might I add, very versatile?
Now I know that most of you are going to continue obsessing over your high heeled shoes and boot (don't forget those stilettos that will look great with that black skirt you saw in the window of Saks the other day) continuing to buy more and more until you have your favorite pair in every available color. Before you do, however, I want to point out some rather interesting complications that can arise from having improper footwear. I've all ready mentioned the varicose veins, knee pain, and bunions I've developed, but I wanted to send another friendly reminder your way. Other problems include bad circulation, nerve damage, hammertoe, spider veins, back problems, thigh pain, ankle weakness, calf muscle disorders (which might account for my pain), osteoarthritis, and stress fractures (http://www.healthatoz.com/healthatoz/Atoz/dc/caz/bone/foot/alert10022001.jsp).
Now that you know some of the problems that can arise, estimate the costs of treatment to fix some of the problems. Remember, though, nerve damage, bad circulation and arthritis cannot be cured and only treated, so think about the costs of medication each month for the rest of your life? Think about your health plan and how much will come out of your pocket and that's for medications alone. What if you need surgery? How much will that cost you? Let me give you some prices that I found on the internet for surgical procedures dealing with bunion and varicose vein removal.
In 2003, according to an investigation by a WHDH TV out of Boston (http://www2.whdh.com/features/articles/specialreport/A303/), bunion removal cost $5,000 at the doctor's offices they had interviewed. I then read on another site that you shouldn't pay over $2500 (http://www.zfootdoc.com/new_page_28.htm) per bunion but I don't think this includes hospital fees, so make sure you shop around. Hopefully you'll have the insurance to cover the entire operation and that they will consider the procedure non-cosmetic.
Varicose veins can cost anywhere from $600-$2000 depending on the number needed to be removed. This price doesn't include anesthesia or hospital fees (http://www.venous-info.com/education/legup/leg07.html). Remember varicose veins will also have to be proven to be harming your health as some insurance will also consider this cosmetic and leave you to pick up the tab.
After you get the procedures done, remember, as soon as you put your foot back into that strappy black pump or stiletto, you are starting the process all over again. For some, buying shoes is a seemingly sweet addiction, that can have irreversible and damaging consequences. With every wear, you feel comparable to the women in the magazines and on the billboards. You feel like you're going a step further in the office and with your boyfriend, but actually, you're going two steps closer to the operating table all for the sake of looking good in that pinstripe suit and that sexy black number. Again, I ask, "Why do we succumb to the expectations of society and wear shoes that are do more damage than good all for the sake of impressing a materialistic society?"
I've been the in the corporate world, but I first started out in a production job that allowed me to wear tennis shoes. Then I moved to a desk position, but I worked for a guy who was very laid back and didn't care what I had on my feet. Soon after I was promoted once again to work under a former "Miss Georgia." Needless to say, the wrath of the fashion police was about to come down upon me with a fiery vengeance.
My clothes were analyzed and some of them passed, but all of my shoes failed. She pulled items straight from her closet that were practically brand-new and soon, I was transformed and very uncomfortable. Trying to walk at work looked very much like a young child trying to walk on stilts-step, step, stumble-and wasn't a graceful site in the least. Some days I felt like I would never get to my desk. As soon as I did reach my cubicle, I would kick my shoes off and wiggle my toes that were screaming for oxygen and room.
My heels hurt and my arches felt like they were stretched beyond belief and were on the verge of snapping. Other parts of my legs hurt like my shins, knees, and thighs. I began to hate the shoes and secretly swore to burn them one day by dousing them first with kerosene and laughing before I lit the match. Then the scenario would be ruined by an interruption, "We have to go upstairs to for a meeting then we have to greet guests and escort them to the show." In my head I added, "Where we will stand for the next 60 minutes on over arched, too narrow of a foot bead, and outrageously tall heels of death. I can't wait."
When the shoe hand out stopped, I was released from the nest (with an observing eye) to buy my own pair of heels whether they were boots or sandals or any other type of style the beauty queen threw at me. Whatever they were, she would always say, "These are stylish and worth every penny." I remember when looking at the price tags, my eyes would widen and my feet would scream, "No, please don't put me in those things. I'll massage myself from now on…anything…just not those torture chambers." I could also hear my husband's voice, "You spent how much??? $70.00 on shoes that barely cover your feet….Whatttt!!"
To a lot of women, $70.00 for a sexy pair of heels is a steal as most pay $100.00 or more. That's not even getting into brands like Gucci or Prada. These prices reflect more towards Gianni Bini or a brand you can get at Dillards (which is where the shoe queen and I frequented). I quickly learned that all high heels were way overpriced and went to Payless without the shoe queen to find something more affordable but equally as damaging. Hey, if I was going to pay the price in the long run, might as well keep the front-end costs low so I could save up for the treatment expenses later.
Finally, I'd had enough of the shoe queen's demands and worked for a different company altogether. There I ran into the shoe nazi who paid $500.00 to $800.00 a pair for Prada and Gucci heels. I was able to touch a couple of them before shipping them off and they amazingly looked like some I saw at Payless for twelve bucks.
At the new company, I got to experience walking in heels on a concrete floor in a store colored like the MacDonald's playground. Then I started incorporating black tennis shoes with my black slacks and needless to say, I was left out of many publicity photos. Yet, we advertised "people can come in in their pajamas." I don't know about you, but I'd rather not see people who look like the fashion police when I'm in my PJ's.
Needless to say, I had enough of the fashionistas and drama queens, so I quit. The damage was done. My feet and legs, only 27 years of age, now feel haggard and older than they really are. Now I sit here with mysterious knee aches, varicose veins and two bunions that will need to be removed soon. The only shoes I can really fit into are these Crocs I picked up at the shoe store and amazingly enough, the right one is almost too narrow. I say "amazingly" because these shoes have been compared to actual boats, but hey they float. Doesn't everyone want a pair of floating shoes that are lightweight and might I add, very versatile?
Now I know that most of you are going to continue obsessing over your high heeled shoes and boot (don't forget those stilettos that will look great with that black skirt you saw in the window of Saks the other day) continuing to buy more and more until you have your favorite pair in every available color. Before you do, however, I want to point out some rather interesting complications that can arise from having improper footwear. I've all ready mentioned the varicose veins, knee pain, and bunions I've developed, but I wanted to send another friendly reminder your way. Other problems include bad circulation, nerve damage, hammertoe, spider veins, back problems, thigh pain, ankle weakness, calf muscle disorders (which might account for my pain), osteoarthritis, and stress fractures (http://www.healthatoz.com/healthatoz/Atoz/dc/caz/bone/foot/alert10022001.jsp).
Now that you know some of the problems that can arise, estimate the costs of treatment to fix some of the problems. Remember, though, nerve damage, bad circulation and arthritis cannot be cured and only treated, so think about the costs of medication each month for the rest of your life? Think about your health plan and how much will come out of your pocket and that's for medications alone. What if you need surgery? How much will that cost you? Let me give you some prices that I found on the internet for surgical procedures dealing with bunion and varicose vein removal.
In 2003, according to an investigation by a WHDH TV out of Boston (http://www2.whdh.com/features/articles/specialreport/A303/), bunion removal cost $5,000 at the doctor's offices they had interviewed. I then read on another site that you shouldn't pay over $2500 (http://www.zfootdoc.com/new_page_28.htm) per bunion but I don't think this includes hospital fees, so make sure you shop around. Hopefully you'll have the insurance to cover the entire operation and that they will consider the procedure non-cosmetic.
Varicose veins can cost anywhere from $600-$2000 depending on the number needed to be removed. This price doesn't include anesthesia or hospital fees (http://www.venous-info.com/education/legup/leg07.html). Remember varicose veins will also have to be proven to be harming your health as some insurance will also consider this cosmetic and leave you to pick up the tab.
After you get the procedures done, remember, as soon as you put your foot back into that strappy black pump or stiletto, you are starting the process all over again. For some, buying shoes is a seemingly sweet addiction, that can have irreversible and damaging consequences. With every wear, you feel comparable to the women in the magazines and on the billboards. You feel like you're going a step further in the office and with your boyfriend, but actually, you're going two steps closer to the operating table all for the sake of looking good in that pinstripe suit and that sexy black number. Again, I ask, "Why do we succumb to the expectations of society and wear shoes that are do more damage than good all for the sake of impressing a materialistic society?"
Childhood Obesity & the Orthopedic Implication
More than 300,000 deaths, annually, are attributed to obesity with
healthcare costs exceeding $60 billion dollars. Of these statistics, an
increasing number of individuals affected involve children. Obesity in
children is at an all time high with statistics as never seen before.
While the condition may be hereditary, genetic or a product of the
environment, it is important that parents become vitally aware, and take
responsibility, for the growth and development of children which
includes education and guidance in weight control, fitness and
nutrition. Understanding the health implications obesity will play on a
child's welfare is the first line of defense in educating parents in the
appropriate course of action.
In children, the growth plates, particular in the legs, are susceptible to damage. When a child reaches a level of obesity, these growth plates become impaired, unable to function properly, and result in inadequate bone growth. This decrease in growth leads to flat feet, narrowing of the arches, knee pain, back pain and irregular hip position. For most children, these pains and deformities will progress into adulthood with little chance for recovery. It is the excess weight, on a child's body, which creates these deformed growth patterns which then leads to a cyclical effect in which the child is unable to perform any level of physical activity and, thus, gains more weight. The key, then, is to prevent obesity from occurring.
In addition to the growth impairment and pain associated with obesity, many obese children find they are unable to perform physical activities due to the inability to rise in and out of a chair, inability to mobilize the hips and are often discouraged due to emotional factors including self esteem, peer pressure and depression. With decreased mobility, coupled with emotional distress, the child may turn to eating as a comfort to ease the pain of social non-acceptance. For these children, an individual or family styled fitness program, outside of school, is vitally important in addition to education, at home, in proper eating habits.
Fractures are quite common in obese children. Although not much research has been done as to the causal relationship of fractures in obese children, the theory lies in the malnutrition, which leads to bone deterioration, coupled with the lack of mobility which may attribute to frequent falls. Suffering from a fracture only further complicates the health of the obese child as the recovery is delayed due to improper bone growth structure.
For parents of an obese child, education is paramount. Understanding the full affect obesity will have a child, during growth and development, should be a primary driving force behind the motivation to make a change. Beyond education, parents should educate, motivate and participate in regular exercise and dietary programs at home encouraging the obese child to participate without ridicule. Leading by example will improve the health of the child and will instill the necessary education and information required to continue a healthy lifestyle into adulthood.
In children, the growth plates, particular in the legs, are susceptible to damage. When a child reaches a level of obesity, these growth plates become impaired, unable to function properly, and result in inadequate bone growth. This decrease in growth leads to flat feet, narrowing of the arches, knee pain, back pain and irregular hip position. For most children, these pains and deformities will progress into adulthood with little chance for recovery. It is the excess weight, on a child's body, which creates these deformed growth patterns which then leads to a cyclical effect in which the child is unable to perform any level of physical activity and, thus, gains more weight. The key, then, is to prevent obesity from occurring.
In addition to the growth impairment and pain associated with obesity, many obese children find they are unable to perform physical activities due to the inability to rise in and out of a chair, inability to mobilize the hips and are often discouraged due to emotional factors including self esteem, peer pressure and depression. With decreased mobility, coupled with emotional distress, the child may turn to eating as a comfort to ease the pain of social non-acceptance. For these children, an individual or family styled fitness program, outside of school, is vitally important in addition to education, at home, in proper eating habits.
Fractures are quite common in obese children. Although not much research has been done as to the causal relationship of fractures in obese children, the theory lies in the malnutrition, which leads to bone deterioration, coupled with the lack of mobility which may attribute to frequent falls. Suffering from a fracture only further complicates the health of the obese child as the recovery is delayed due to improper bone growth structure.
For parents of an obese child, education is paramount. Understanding the full affect obesity will have a child, during growth and development, should be a primary driving force behind the motivation to make a change. Beyond education, parents should educate, motivate and participate in regular exercise and dietary programs at home encouraging the obese child to participate without ridicule. Leading by example will improve the health of the child and will instill the necessary education and information required to continue a healthy lifestyle into adulthood.
Check Your Technique: Balance Ball Squats
There are those out there that feel that heavy squats are not only the
cornerstone of any true leg workout, but also that it is a necessity to
any workout. Unfortunately, while there may be great benefits to squats,
there are those of us that for one reason or another cannot do them. So
what are we to do?
Well, you could do machines. There are many machines that simulate the same range of motion that a squat has, however, these machines are awkward to use and sometimes very difficult to get in and out of. There must be some way that people with physically limitations can still reap the rewards that people with a full range of motion get. Well there is: balance ball (aka: the Swiss ball) squats.
Balance balls are the grey, red or blue beach-ball-looking-things that you largely ignore at the gym. They come in a variety of sizes, which isn't so important for this exercise, but which is important for other exercises based on your height. Using this simple piece of equipment even those that have not been able to do squats in the past can do the same leg strengthening workout that they may have never been able to do in the past.
Before we go over form: is this exercise for you? The following limitations are good signs that you are better off doing balance ball squats than the more traditional free weight squats: people new to working out, lower back pain, neck pain (hypertension), knee pain, and hip pain. If you fall into any of these categories, you would do best to begin with balance ball squats and try to work your way up to free weights.
Balance Ball Squats
- Find some space
To do this exercise you should find open wall space or a flat sided pillar by which to put the ball.
-Getting into position
Hold the ball against the wall and turn, placing your back on the ball at the midpoint. You can move the ball up or down depending on how comfortable the ball feels on different parts of your back.
- Set your feet
Move your feet away from the ball so that they are out past your body. Keeping your feet a little in front of you will help you to prevent your knees from going over your toes. This type of positioning will put the greatest emphasis on the tops of your legs and secondary emphasis on your hamstrings and calves.
Putting your feet shoulder width apart will evenly distribute the overall emphasis on your quads. Spreading your feet further apart will put great emphasis on your inner thighs. While moving your feet closer together will put more emphasis on your outer thighs.
- Lowering yourself
The distance that you are able to squat down is largely dependent on any physical limitations that you might have, but the further that you can get to your legs being parallel to the ground the better. Don't worry about going deeper than parallel; the extra emphasis on your gluts can be actually be much harder on your knees when returning to your starting position.
As far as where to keep your hands it is kind of up to you. It doesn't really matter whether you put your hands on your hips, out in front of you (this adds balance) or on your head. If you need a little assistance it is okay to keep your hands on your knees, but it should only be done as a last resort.
- Standing and repeating
When standing back up from your squat make sure that you don't lock your knees, this puts far too much pressure on your joints and by keeping a slight bend in your legs you will keep more emphasis on your quads. Repeat as many times as you can manage up to about 20. If you can do 20 reps you can start adding weight like holding a medicine ball to your chest or a dumbbell in each hand.
Learning to properly perform the balance ball squat can be very important, especially if you have a limited range of motion. Never let your limitations lead you to ignoring a muscle group, especially one as vitally important as your legs. Being in the gym in the first place is a sign that you are looking to do the best you can with your body; don't take it for granted.
Well, you could do machines. There are many machines that simulate the same range of motion that a squat has, however, these machines are awkward to use and sometimes very difficult to get in and out of. There must be some way that people with physically limitations can still reap the rewards that people with a full range of motion get. Well there is: balance ball (aka: the Swiss ball) squats.
Balance balls are the grey, red or blue beach-ball-looking-things that you largely ignore at the gym. They come in a variety of sizes, which isn't so important for this exercise, but which is important for other exercises based on your height. Using this simple piece of equipment even those that have not been able to do squats in the past can do the same leg strengthening workout that they may have never been able to do in the past.
Before we go over form: is this exercise for you? The following limitations are good signs that you are better off doing balance ball squats than the more traditional free weight squats: people new to working out, lower back pain, neck pain (hypertension), knee pain, and hip pain. If you fall into any of these categories, you would do best to begin with balance ball squats and try to work your way up to free weights.
Balance Ball Squats
- Find some space
To do this exercise you should find open wall space or a flat sided pillar by which to put the ball.
-Getting into position
Hold the ball against the wall and turn, placing your back on the ball at the midpoint. You can move the ball up or down depending on how comfortable the ball feels on different parts of your back.
- Set your feet
Move your feet away from the ball so that they are out past your body. Keeping your feet a little in front of you will help you to prevent your knees from going over your toes. This type of positioning will put the greatest emphasis on the tops of your legs and secondary emphasis on your hamstrings and calves.
Putting your feet shoulder width apart will evenly distribute the overall emphasis on your quads. Spreading your feet further apart will put great emphasis on your inner thighs. While moving your feet closer together will put more emphasis on your outer thighs.
- Lowering yourself
The distance that you are able to squat down is largely dependent on any physical limitations that you might have, but the further that you can get to your legs being parallel to the ground the better. Don't worry about going deeper than parallel; the extra emphasis on your gluts can be actually be much harder on your knees when returning to your starting position.
As far as where to keep your hands it is kind of up to you. It doesn't really matter whether you put your hands on your hips, out in front of you (this adds balance) or on your head. If you need a little assistance it is okay to keep your hands on your knees, but it should only be done as a last resort.
- Standing and repeating
When standing back up from your squat make sure that you don't lock your knees, this puts far too much pressure on your joints and by keeping a slight bend in your legs you will keep more emphasis on your quads. Repeat as many times as you can manage up to about 20. If you can do 20 reps you can start adding weight like holding a medicine ball to your chest or a dumbbell in each hand.
Learning to properly perform the balance ball squat can be very important, especially if you have a limited range of motion. Never let your limitations lead you to ignoring a muscle group, especially one as vitally important as your legs. Being in the gym in the first place is a sign that you are looking to do the best you can with your body; don't take it for granted.
Preventing Anterior Cruciate Ligament Injuries in Alpine Skiing
After three days of continuous snow, the clouds finally parted and the
resort glistened under acres of sparkling snow. For the first time in
your lives, you and your friends were going to get to experience the
thrill of deep powder on your winter vacation.
The group hooted and hollered as you glided your way down the untracked slopes. And then suddenly, it happened. Your wife took what appeared to be a simple fall. But she wasn't getting up. Complaining of excruciating knee pain, the ski patrol guessed that she injured her anterior cruciate ligament, or ACL. In an instant, your vacation was ruined.
Few of us like to dwell on getting injured when we head out for a day of skiing. That would be a bit morbid. However, with the declining states of fitness in adults and recent evolutions in ski equipment, you may be at more risk for injury than you'd care to admit.
It's estimated that there are more than 525,000 ski injuries per year. As many as 85,000 to 100,000 of these incidents represent injuries to the ACL. Since one third of all ACL patients require surgery at a national average of $17,000 per reconstruction, the estimated annual cost is more than $1.5 billion1. And that doesn't include the costs of the initial evaluation, non-surgical care or future medical treatment for those who develop post-traumatic arthritis. But it's not all bad news. Fortunately, there are ways that you can significantly reduce your potential for serious knee injury.
Modern ski binding mechanisms have helped to protect the lower leg against injury. But it is not necessarily a result of improved release capabilities. One study showed that 95% of all the bindings tested had at least one fault and 50% of the bindings had release levels that were more than 20% above the recommended standards for the individual2. One somewhat discouraging factor is the widely held belief that binding settings are made based on the ability of the mechanism to resist fracture to the tibia, not injury to the knee3.
The most effective methods for reducing equipment related, lower extremity injuries are good ski instruction that helps the beginning skier move out of the beginner ranks as quickly as possible, appropriately adjusted bindings and frequent self-testing of binding mechanisms4.
Most people that injure their ACL complain of one or more of the following: an audible "popping" sound, they feel their knee "give way," experience so much pain that they must stop activity or they sustain swelling within a few hours of injury5.
There are a number of causes of injury to the ACL; some predictable, some not. They include anatomical problems of the knee joint, neuromuscular elements, hormonal changes and poor skiing technique.
Anatomical Considerations of the Knee Joint
While relatively rare, some skiers suffer from an impingement, or "pinching" of the ACL against the notch at the end of the bones of the leg; either the tibia or femur6. Instead of having a smooth, U-shaped notch, a small percentage of skiers have a narrow, A-shaped notch, which is responsible for the shearing forces of the ACL against bone.
Neuromuscular Elements
The balance between the quadriceps (front of thigh) and hamstring (back of thigh) power and function is crucial to knee stability. "The typical quadriceps/hamstring strength ratio is somewhere around 60/40, whether you're a recreational skier or a world-class athlete," says Michael Torry, Ph.D., Director of Biomechanics at the Steadman-Hawkins Sports Medicine Foundation in Vail, Colorado. "Interestingly, as athletes become stronger through training, the ratio remains the same, but the power and endurance of the muscle groups increase." Other investigators have reported that strong quadriceps contraction between 10° to 30°of knee flexion significantly increases ACL strain while hamstring contraction helps to shield against it7.
Women and ACL Injury Rates
According to Carl F. Ettlinger, MS, Director of Vermont Safety Research in Underhill Center, Vermont, "Given equal skill levels, women are 2.5 times more likely to injure their ACL's, whereas men are more likely to sustain fractures and other blunt-impact injuries."
Research has found that female athletes rely more on their quadriceps muscles and take significantly longer to generate maximum hamstring muscle force than their male counterparts. Other studies have shown that women have more knee and muscle laxity than their male counterparts8. Therefore, in female athletes with above average hamstring flexibility, the protective ability of this muscle group may be diminished and the forces required to stabilize the knee are transferred directly to the ligaments. Though these elements may not be the primary cause of ACL injury in women, they may predispose female athletes to ACL disruption9.
Hormonal Changes in Women
As stated earlier, non-contact anterior cruciate ligament injuries are believed to be two to six times more common in women than in men, particularly in basketball, alpine skiing, volleyball and apparatus gymnastics10. One hypothesis is that any rise in the hormone estrogen, which can relax soft tissue, may predispose female athletes to ACL tears. Estrogen, a hormone with receptors in the human ACL, reduces the tensile strength of the ACL during mid-cycle of the menstrual period. In addition, estrogen has been reported to decrease fine motor skills by acting on the central and peripheral nervous systems11.
Poor Skiing Technique
Poor skiing technique refers to any lapse in balance or alignment that predisposes a joint to injury. This includes "bad luck." According to Ettlinger, ACL injuries on the ski slope often result not from falling but from an attempt to recover from a loss of balance. "People get off balance, they get injured, then they fall," says Ettlinger12." As opposed to running, jumping or soccer, most ACL injuries in alpine skiing result from internal rotation of the tibia with the knee flexed beyond 90 degrees, a position that results when a skier, falling backward, catches the inside edge of the tail of the downhill ski. Ettlinger states that there are two major types of falls that contribute to ACL injuries.
Common Types of Falls
There are a number of mechanisms of injury, or types of falls that can result in ACL ruptures. The two types that are best documented are the boot-induced landing and the phantom-foot phenomenon1.
The BOOT-INDUCED LANDING is probably the easiest injury to avoid. It typically occurs when the skier begins a jump off balance with their weight to the rear. When the skier lands, the tail of the uphill ski hits first. As the center of pressure against the bottom of the ski moves forward, the pressure of the boot against the back of the leg increases. At the same time, the muscles of the skier's leg automatically contract to hold the leg in a fully extended position. By the time the portion of the ski under the boot heel hits the snow, there is no laxity left in the skier's legs to absorb the jarring impact and the back of the boot drives the tibia out from under the femur, tearing the ACL.
The PHANTOM FOOT SYNDROME is the most common type of fall leading to ACL injury. It is called the Phantom Foot Syndrome because the tail of the downhill ski acts like a lever that points in a direction opposite that of the human foot.
In the phantom foot syndrome, the skier falls backward between the skis, catching the inside edge of the downhill ski, driving the leg into forced internal rotation. There are three types of situations that can lead to the Phantom Foot Syndrome:
1) Attempting to get up while still moving after a fall.
2) Attempting a recovery from an off-balance position.
3) Attempting to sit down after losing control.
Prevention of ACL Injuries
Now that you've heard the bad news, its time for the good. There are a number of steps that you can take to help minimize your risk for injuring your ACL. These include proper conditioning, better skiing mechanics and reducing unsubstantiated risk-taking behavior.
One popular myth is that pre-season conditioning will make you immune to injury. "Preseason conditioning programs don't reduce knee injuries in alpine skiing," says Robert Johnson, MD, an orthopedic surgeon at the University of Vermont who has published several studies on ski injuries. "Many claims have been made but none have ever been proven. World-class skiers have the highest ACL injury rates and they're the best trained and the strongest."
Pre-season conditioning will, however, help balance the quadriceps/hamstrings strength ratio, and strengthen small muscles groups, resulting in more stability of the knee. "While it's impossible to completely prevent injuries to the ACL, there are a number of sound conditioning exercises that you can use to help minimize your risk for getting hurt," says Steve Stalzer, Director of Therapy at the Howard Head Sports Medicine Center in Vail, Colorado. The Howard Head Center is the physical therapy group for Vail Valley Medical Center and is a provider for the U.S. Ski team. "Skiers should focus on "closed-chain" exercises. Closed-chain exercises involve both ends of the joints being connected to immovable objects. For instance, a squat or leg press anchors the foot when standing on the ground, while the femur is anchored at the hip joint. Closed-chain exercises increase joint compressive forces and cause more hamstring contraction when compared to open-chain exercises. The effect is increased knee stability and decreased ACL strain." An example of an "open-chain" exercise is the seated knee extension. For more information regarding pre-season conditioning programs, please check with a licensed physical therapist or your local fitness facility.
Minimizing Phantom Foot Syndrome Injuries
The most effective way to reverse the trend is to immediately employ the following maneuvers:
1) Push your arms forward.
2) Move your feet together.
3) Keep your hands over your skis.
In Summary… No one wants to think about getting injured. But skiing, by nature, carries a number of inherent risks; risks that can be minimized through proper preseason conditioning and practicing the described response strategies.
"Some of the most valuable instruction that skiers can receive, is how to correctly fall," says Dr. Torry. "It's important for skiers at all levels to acknowledge that occasionally, they're going to go down. There's nothing wrong with that."
1. Kao JT, Giangarra CE, Singer G, et al: A comparison of outpatient and inpatient anterior cruciate ligament reconstruction surgery. Arthroscopy 1995:11(2):151-156. 2. Hauser W: Experimental prospective skiing injury study, in Johnson RJ, Mote CD Jr, Binet M-H (eds): Skiing Trauma and Safety: Seventh International Symposium. Philadelphia, American Society for Testing and Materials, 1989, pp18-24. 3. Hunter RE: Skiing Injuries. The American Journal of Sports Medicine 1999:27 p381. 4. Ekeland A, Holtmoen A, Lystad H: Lower extremity equipment-related injuries in alpine recreational skiers. American Journal of Sports Medicine 21: 201-205, 1993. 5. The CareNotes System Anterior Cruciate Ligament Injury Englewood, Colorado: Micromedex, Inc., 2000. 6. Harner CD, Paulos LE, Greenwald AE, et al: Detailed analysis of patients with bilateral anterior cruciate ligament injuries. American Journal of Sportsmedicine 1994;22(1):37-43. 7. Draganich LF, Vahey JW: An in vitro study of anterior cruciate ligament strain induced by quadriceps and hamstrings forces. Journal of Orthopedic Research 1990;8(1):57-63. 8. Huston LJ, Wojtys EM: Neuromuscular performance characteristics in elite female athletes. American Journal of Sports Medicine 1996;24(4):427-436. 9. Wojtys EJ, Huston LJ, Ashton-Miller JA: Active knee stiffness differs between young men and women. Presented at the annual meeting of AOSSM, July 12-15, 1998, Vancouver, British Columbia. 10. De Loes M: Epidemiology of sports injuries in the Swiss organization, youth and Sports, 1987-1989: injuries, exposure and risks of main diagnoses. International Journal of Sports Medicine 1995; 16(2):134-138. 11. Posthuma BW, Bass MJ, Bull SB, et al: detecting changes in functional ability in women with premenstrual syndrome. American Journal of Obstetrics and Gynecology 1987;156(2):275-278. 12. News Briefs, The Physician and Sportsmedicine, Vol. 27, No. 10, October 1, 1999.
The group hooted and hollered as you glided your way down the untracked slopes. And then suddenly, it happened. Your wife took what appeared to be a simple fall. But she wasn't getting up. Complaining of excruciating knee pain, the ski patrol guessed that she injured her anterior cruciate ligament, or ACL. In an instant, your vacation was ruined.
Few of us like to dwell on getting injured when we head out for a day of skiing. That would be a bit morbid. However, with the declining states of fitness in adults and recent evolutions in ski equipment, you may be at more risk for injury than you'd care to admit.
It's estimated that there are more than 525,000 ski injuries per year. As many as 85,000 to 100,000 of these incidents represent injuries to the ACL. Since one third of all ACL patients require surgery at a national average of $17,000 per reconstruction, the estimated annual cost is more than $1.5 billion1. And that doesn't include the costs of the initial evaluation, non-surgical care or future medical treatment for those who develop post-traumatic arthritis. But it's not all bad news. Fortunately, there are ways that you can significantly reduce your potential for serious knee injury.
Modern ski binding mechanisms have helped to protect the lower leg against injury. But it is not necessarily a result of improved release capabilities. One study showed that 95% of all the bindings tested had at least one fault and 50% of the bindings had release levels that were more than 20% above the recommended standards for the individual2. One somewhat discouraging factor is the widely held belief that binding settings are made based on the ability of the mechanism to resist fracture to the tibia, not injury to the knee3.
The most effective methods for reducing equipment related, lower extremity injuries are good ski instruction that helps the beginning skier move out of the beginner ranks as quickly as possible, appropriately adjusted bindings and frequent self-testing of binding mechanisms4.
Most people that injure their ACL complain of one or more of the following: an audible "popping" sound, they feel their knee "give way," experience so much pain that they must stop activity or they sustain swelling within a few hours of injury5.
There are a number of causes of injury to the ACL; some predictable, some not. They include anatomical problems of the knee joint, neuromuscular elements, hormonal changes and poor skiing technique.
Anatomical Considerations of the Knee Joint
While relatively rare, some skiers suffer from an impingement, or "pinching" of the ACL against the notch at the end of the bones of the leg; either the tibia or femur6. Instead of having a smooth, U-shaped notch, a small percentage of skiers have a narrow, A-shaped notch, which is responsible for the shearing forces of the ACL against bone.
Neuromuscular Elements
The balance between the quadriceps (front of thigh) and hamstring (back of thigh) power and function is crucial to knee stability. "The typical quadriceps/hamstring strength ratio is somewhere around 60/40, whether you're a recreational skier or a world-class athlete," says Michael Torry, Ph.D., Director of Biomechanics at the Steadman-Hawkins Sports Medicine Foundation in Vail, Colorado. "Interestingly, as athletes become stronger through training, the ratio remains the same, but the power and endurance of the muscle groups increase." Other investigators have reported that strong quadriceps contraction between 10° to 30°of knee flexion significantly increases ACL strain while hamstring contraction helps to shield against it7.
Women and ACL Injury Rates
According to Carl F. Ettlinger, MS, Director of Vermont Safety Research in Underhill Center, Vermont, "Given equal skill levels, women are 2.5 times more likely to injure their ACL's, whereas men are more likely to sustain fractures and other blunt-impact injuries."
Research has found that female athletes rely more on their quadriceps muscles and take significantly longer to generate maximum hamstring muscle force than their male counterparts. Other studies have shown that women have more knee and muscle laxity than their male counterparts8. Therefore, in female athletes with above average hamstring flexibility, the protective ability of this muscle group may be diminished and the forces required to stabilize the knee are transferred directly to the ligaments. Though these elements may not be the primary cause of ACL injury in women, they may predispose female athletes to ACL disruption9.
Hormonal Changes in Women
As stated earlier, non-contact anterior cruciate ligament injuries are believed to be two to six times more common in women than in men, particularly in basketball, alpine skiing, volleyball and apparatus gymnastics10. One hypothesis is that any rise in the hormone estrogen, which can relax soft tissue, may predispose female athletes to ACL tears. Estrogen, a hormone with receptors in the human ACL, reduces the tensile strength of the ACL during mid-cycle of the menstrual period. In addition, estrogen has been reported to decrease fine motor skills by acting on the central and peripheral nervous systems11.
Poor Skiing Technique
Poor skiing technique refers to any lapse in balance or alignment that predisposes a joint to injury. This includes "bad luck." According to Ettlinger, ACL injuries on the ski slope often result not from falling but from an attempt to recover from a loss of balance. "People get off balance, they get injured, then they fall," says Ettlinger12." As opposed to running, jumping or soccer, most ACL injuries in alpine skiing result from internal rotation of the tibia with the knee flexed beyond 90 degrees, a position that results when a skier, falling backward, catches the inside edge of the tail of the downhill ski. Ettlinger states that there are two major types of falls that contribute to ACL injuries.
Common Types of Falls
There are a number of mechanisms of injury, or types of falls that can result in ACL ruptures. The two types that are best documented are the boot-induced landing and the phantom-foot phenomenon1.
The BOOT-INDUCED LANDING is probably the easiest injury to avoid. It typically occurs when the skier begins a jump off balance with their weight to the rear. When the skier lands, the tail of the uphill ski hits first. As the center of pressure against the bottom of the ski moves forward, the pressure of the boot against the back of the leg increases. At the same time, the muscles of the skier's leg automatically contract to hold the leg in a fully extended position. By the time the portion of the ski under the boot heel hits the snow, there is no laxity left in the skier's legs to absorb the jarring impact and the back of the boot drives the tibia out from under the femur, tearing the ACL.
The PHANTOM FOOT SYNDROME is the most common type of fall leading to ACL injury. It is called the Phantom Foot Syndrome because the tail of the downhill ski acts like a lever that points in a direction opposite that of the human foot.
In the phantom foot syndrome, the skier falls backward between the skis, catching the inside edge of the downhill ski, driving the leg into forced internal rotation. There are three types of situations that can lead to the Phantom Foot Syndrome:
1) Attempting to get up while still moving after a fall.
2) Attempting a recovery from an off-balance position.
3) Attempting to sit down after losing control.
Prevention of ACL Injuries
Now that you've heard the bad news, its time for the good. There are a number of steps that you can take to help minimize your risk for injuring your ACL. These include proper conditioning, better skiing mechanics and reducing unsubstantiated risk-taking behavior.
One popular myth is that pre-season conditioning will make you immune to injury. "Preseason conditioning programs don't reduce knee injuries in alpine skiing," says Robert Johnson, MD, an orthopedic surgeon at the University of Vermont who has published several studies on ski injuries. "Many claims have been made but none have ever been proven. World-class skiers have the highest ACL injury rates and they're the best trained and the strongest."
Pre-season conditioning will, however, help balance the quadriceps/hamstrings strength ratio, and strengthen small muscles groups, resulting in more stability of the knee. "While it's impossible to completely prevent injuries to the ACL, there are a number of sound conditioning exercises that you can use to help minimize your risk for getting hurt," says Steve Stalzer, Director of Therapy at the Howard Head Sports Medicine Center in Vail, Colorado. The Howard Head Center is the physical therapy group for Vail Valley Medical Center and is a provider for the U.S. Ski team. "Skiers should focus on "closed-chain" exercises. Closed-chain exercises involve both ends of the joints being connected to immovable objects. For instance, a squat or leg press anchors the foot when standing on the ground, while the femur is anchored at the hip joint. Closed-chain exercises increase joint compressive forces and cause more hamstring contraction when compared to open-chain exercises. The effect is increased knee stability and decreased ACL strain." An example of an "open-chain" exercise is the seated knee extension. For more information regarding pre-season conditioning programs, please check with a licensed physical therapist or your local fitness facility.
Minimizing Phantom Foot Syndrome Injuries
The most effective way to reverse the trend is to immediately employ the following maneuvers:
1) Push your arms forward.
2) Move your feet together.
3) Keep your hands over your skis.
In Summary… No one wants to think about getting injured. But skiing, by nature, carries a number of inherent risks; risks that can be minimized through proper preseason conditioning and practicing the described response strategies.
"Some of the most valuable instruction that skiers can receive, is how to correctly fall," says Dr. Torry. "It's important for skiers at all levels to acknowledge that occasionally, they're going to go down. There's nothing wrong with that."
1. Kao JT, Giangarra CE, Singer G, et al: A comparison of outpatient and inpatient anterior cruciate ligament reconstruction surgery. Arthroscopy 1995:11(2):151-156. 2. Hauser W: Experimental prospective skiing injury study, in Johnson RJ, Mote CD Jr, Binet M-H (eds): Skiing Trauma and Safety: Seventh International Symposium. Philadelphia, American Society for Testing and Materials, 1989, pp18-24. 3. Hunter RE: Skiing Injuries. The American Journal of Sports Medicine 1999:27 p381. 4. Ekeland A, Holtmoen A, Lystad H: Lower extremity equipment-related injuries in alpine recreational skiers. American Journal of Sports Medicine 21: 201-205, 1993. 5. The CareNotes System Anterior Cruciate Ligament Injury Englewood, Colorado: Micromedex, Inc., 2000. 6. Harner CD, Paulos LE, Greenwald AE, et al: Detailed analysis of patients with bilateral anterior cruciate ligament injuries. American Journal of Sportsmedicine 1994;22(1):37-43. 7. Draganich LF, Vahey JW: An in vitro study of anterior cruciate ligament strain induced by quadriceps and hamstrings forces. Journal of Orthopedic Research 1990;8(1):57-63. 8. Huston LJ, Wojtys EM: Neuromuscular performance characteristics in elite female athletes. American Journal of Sports Medicine 1996;24(4):427-436. 9. Wojtys EJ, Huston LJ, Ashton-Miller JA: Active knee stiffness differs between young men and women. Presented at the annual meeting of AOSSM, July 12-15, 1998, Vancouver, British Columbia. 10. De Loes M: Epidemiology of sports injuries in the Swiss organization, youth and Sports, 1987-1989: injuries, exposure and risks of main diagnoses. International Journal of Sports Medicine 1995; 16(2):134-138. 11. Posthuma BW, Bass MJ, Bull SB, et al: detecting changes in functional ability in women with premenstrual syndrome. American Journal of Obstetrics and Gynecology 1987;156(2):275-278. 12. News Briefs, The Physician and Sportsmedicine, Vol. 27, No. 10, October 1, 1999.
A Better Choice for Knee Replacement Surgery
Ever since the first artificial knee joint was fashioned from glass by
Boston surgeon M.N. Petersen, surgeons have known that joint replacement
has been the best way to reverse the crippling effects of arthritis
and other joint diseases. Over the years the evolution of the practice
has been to develop safer, stronger and more biocompatible materials.
But exactly duplicating the form and function of a human joint has not
been without its challenges. Dr. Jan Koenig, Chief of Orthopedics at
NY's Mercy Medical Center explains. "The problem with the early
replacements is we didn't have a good way to attach the prosthesis to
the bone, and we couldn't get the accuracy we can today. In 1972 true
modern knee replacement was started it was the first time we replaced
the patella, the knee cap bone, the distal femur and the proximal tibia,
we put three parts into the knee, and it became a real total knee
replacement."
And while today total knee replacements are done almost as a mater of routine with a high degree of success, bringing renewed mobility to countless numbers of patients - the procedure is still not perfect. Recent studies have shown that the reason why many surgeries fail, is not because of the quality or manufacture of the implanted device, but because of misalignment of the joint during the surgical procedure. Surgeons report that misalignment using traditional techniques is a common outcome. The ability to line up the prosthesis right between the hip and ankle is very important, and it turns out that the window is very narrow, only 3 degrees. If the prosthesis is situated within a 3-degree mark chances are that implant will last a long time. If it is "misaligned or outside that three degrees, chances are that it will fail and loosen and become painful for the patient. When this occurs another procedure is often required to get rid of that pain and then make their limb nice and straight.
But the need for such re-operations is changing, thanks to a unique surgical navigation platform being used by Dr. Koenig and other surgeons across the nation. The system is called the PiGalileo and was developed by Plus Orthopedics. It employs 3-D computer mapping and micro-robotics to provide the surgeon with a degree of accuracy for aligning the implant not possible with the naked eye. This computer assisted surgery technology has been shown to be precise to within minuscule fractions of a millimeter and is completely under the surgeon's control at all times. The system also provides valuable intra-operative feedback in real time to the surgeon - improving precision, and leading to better implant alignment and positioning.
According to Dr. Koenig, "The Key to a successful total knee replacement is to have accuracy and we know if we are accurate within 3 degrees of a mechanical axis we'll have a longer lasting prosthesis. Years ago when we were doing conventional knee replacement the best surgeons were being 70-75% accurate. And that's the best in the country. Now with the early generation computers, we were getting 90% accuracy. But when I utilize the mini robot, that's getting to an accuracy rate of 99.6% and that's pretty darn good." Knee replacement patient Tom Ruckert was one of the first to benefit form the new technique. "I do know medically, I know my knee was in pretty bad condition, arthritis, bone spurs, problems with the knee cap, stretched ligaments. It was kind of a pot porrie of things that could go wrong with your knee. But I do not have any of that now, and that's the amazing thing. I have a knee that will outlive me. It seems to be in perfect position, and Dr. Koenig says its is and I believe him, yeah that system made my knee 100% better."
Currently this surgical navigation platform has been approved only for total knee replacement surgery. However understanding that 3-D visualization and micro robotics are advantageous in any procedure where precise accuracy is critical to patient safety and better outcomes, it is logical to expect that these techniques will soon be in use throughout the field of orthopedic surgery. Clinical trials are already underway for hip and shoulder replacements using similar technologies. Most surgeons agree that this an exciting time, the dawn of a new era in orthopedics, one that could not come soon enough with an aging baby-boomer population. Says Dr. Koenig; "You know the baby boom generation is coming of age now. They're getting arthritis at a much younger age. We are seeing many people in their 30's and 40's who have burnt out their joints and have arthritis. They cant live this way, they can't function this way. Now with the PiGalileo System I can guarantee them an excellent result, and more precise surgery and a safer operation. What we are looking for in longevity in the implants and the baby boomer wants to get back to doing their sports activities, golf, tennis, bicycle riding and traveling. Using the PiGalileo system they can obtain this quicker, they can also go back to work and that's an important part of their lives."
Arthritis and joint diseases continue to take their toll on society, however the latest advances in implants and surgical techniques are keeping both the patient, and the field of orthopedics, "on the move".
And while today total knee replacements are done almost as a mater of routine with a high degree of success, bringing renewed mobility to countless numbers of patients - the procedure is still not perfect. Recent studies have shown that the reason why many surgeries fail, is not because of the quality or manufacture of the implanted device, but because of misalignment of the joint during the surgical procedure. Surgeons report that misalignment using traditional techniques is a common outcome. The ability to line up the prosthesis right between the hip and ankle is very important, and it turns out that the window is very narrow, only 3 degrees. If the prosthesis is situated within a 3-degree mark chances are that implant will last a long time. If it is "misaligned or outside that three degrees, chances are that it will fail and loosen and become painful for the patient. When this occurs another procedure is often required to get rid of that pain and then make their limb nice and straight.
But the need for such re-operations is changing, thanks to a unique surgical navigation platform being used by Dr. Koenig and other surgeons across the nation. The system is called the PiGalileo and was developed by Plus Orthopedics. It employs 3-D computer mapping and micro-robotics to provide the surgeon with a degree of accuracy for aligning the implant not possible with the naked eye. This computer assisted surgery technology has been shown to be precise to within minuscule fractions of a millimeter and is completely under the surgeon's control at all times. The system also provides valuable intra-operative feedback in real time to the surgeon - improving precision, and leading to better implant alignment and positioning.
According to Dr. Koenig, "The Key to a successful total knee replacement is to have accuracy and we know if we are accurate within 3 degrees of a mechanical axis we'll have a longer lasting prosthesis. Years ago when we were doing conventional knee replacement the best surgeons were being 70-75% accurate. And that's the best in the country. Now with the early generation computers, we were getting 90% accuracy. But when I utilize the mini robot, that's getting to an accuracy rate of 99.6% and that's pretty darn good." Knee replacement patient Tom Ruckert was one of the first to benefit form the new technique. "I do know medically, I know my knee was in pretty bad condition, arthritis, bone spurs, problems with the knee cap, stretched ligaments. It was kind of a pot porrie of things that could go wrong with your knee. But I do not have any of that now, and that's the amazing thing. I have a knee that will outlive me. It seems to be in perfect position, and Dr. Koenig says its is and I believe him, yeah that system made my knee 100% better."
Currently this surgical navigation platform has been approved only for total knee replacement surgery. However understanding that 3-D visualization and micro robotics are advantageous in any procedure where precise accuracy is critical to patient safety and better outcomes, it is logical to expect that these techniques will soon be in use throughout the field of orthopedic surgery. Clinical trials are already underway for hip and shoulder replacements using similar technologies. Most surgeons agree that this an exciting time, the dawn of a new era in orthopedics, one that could not come soon enough with an aging baby-boomer population. Says Dr. Koenig; "You know the baby boom generation is coming of age now. They're getting arthritis at a much younger age. We are seeing many people in their 30's and 40's who have burnt out their joints and have arthritis. They cant live this way, they can't function this way. Now with the PiGalileo System I can guarantee them an excellent result, and more precise surgery and a safer operation. What we are looking for in longevity in the implants and the baby boomer wants to get back to doing their sports activities, golf, tennis, bicycle riding and traveling. Using the PiGalileo system they can obtain this quicker, they can also go back to work and that's an important part of their lives."
Arthritis and joint diseases continue to take their toll on society, however the latest advances in implants and surgical techniques are keeping both the patient, and the field of orthopedics, "on the move".
What is Viscosupplementation for Osteoarthritis of the Knee?
A process that relies on a series of injections into the knee joints
with hyaluronic acid, Viscosupplementation is a newly available option
for patients with symptomatic knee osteoarthritis.
The use of hyaluronan (hyaluronic acid, hylan), has been proved for the treatment of osteoarthritis of the knee for patients who have failed treatment with acetaminophen (aspirin). The drug is given as a series of weekly injections directly into the affected knee joint, called viscosupplementation, over three to five weeks.
Hyaluronic acid is a naturally occurring substance found in the synovial (joint) fluid. It acts as a lubricant and enables bones to move smoothly over each other. It also serves as a shock absorber for joint loads like weight, heavy lifting, hard impact exercising, sports, and similar endeavors. Without the aid of this fluid, your bones' ability to function decreases as they begin to grate against each other, causing swelling and pain; this in turn amplifies arthritis.
Hyaluronic acid is naturally created by your body, but in some cases, your body loses its ability to produce this necessary fluid. People with osteoarthritis have a lower concentration of hyaluronic acid in their joints than normal, and this can cause painful suffering. Viscosupplementation may be an excellent way for individuals with osteoarthritis of the knee to alleviate their pain.
There are no immediate pain relieving effects of hyaluronic acid, but over a long period of time, you will find that it does have a pain-lessening effect. Pain, warmth, or slight swelling may occur immediately after the shot, but it doesn't normally last long. An ice pack will help if you feel any of these conditions. Avoid putting excessive weight on the leg, like standing, heavy lifting, or jogging for long periods of time, as this can exacerbate swelling or pain.
You will have less pain in your knee over the course of the injections because of the pain-relieving and anti-inflammatory properties of hyaluronic acid. The injections may also stimulate the body's production of its own hyaluronic acid, and the effects may last for several months.
Viscosupplementation doesn't work for everyone, and it's very expensive. It can only alleviate pain for periods of time, not reverse or delay the progress of osteoarthritis. If your arthritis isn't responding well to your current course of medication and treatment, or if you're trying to delay an inevitable surgery, you may wish to discuss the option of Viscosupplementation with your orthopedic doctor.
The use of hyaluronan (hyaluronic acid, hylan), has been proved for the treatment of osteoarthritis of the knee for patients who have failed treatment with acetaminophen (aspirin). The drug is given as a series of weekly injections directly into the affected knee joint, called viscosupplementation, over three to five weeks.
Hyaluronic acid is a naturally occurring substance found in the synovial (joint) fluid. It acts as a lubricant and enables bones to move smoothly over each other. It also serves as a shock absorber for joint loads like weight, heavy lifting, hard impact exercising, sports, and similar endeavors. Without the aid of this fluid, your bones' ability to function decreases as they begin to grate against each other, causing swelling and pain; this in turn amplifies arthritis.
Hyaluronic acid is naturally created by your body, but in some cases, your body loses its ability to produce this necessary fluid. People with osteoarthritis have a lower concentration of hyaluronic acid in their joints than normal, and this can cause painful suffering. Viscosupplementation may be an excellent way for individuals with osteoarthritis of the knee to alleviate their pain.
There are no immediate pain relieving effects of hyaluronic acid, but over a long period of time, you will find that it does have a pain-lessening effect. Pain, warmth, or slight swelling may occur immediately after the shot, but it doesn't normally last long. An ice pack will help if you feel any of these conditions. Avoid putting excessive weight on the leg, like standing, heavy lifting, or jogging for long periods of time, as this can exacerbate swelling or pain.
You will have less pain in your knee over the course of the injections because of the pain-relieving and anti-inflammatory properties of hyaluronic acid. The injections may also stimulate the body's production of its own hyaluronic acid, and the effects may last for several months.
Viscosupplementation doesn't work for everyone, and it's very expensive. It can only alleviate pain for periods of time, not reverse or delay the progress of osteoarthritis. If your arthritis isn't responding well to your current course of medication and treatment, or if you're trying to delay an inevitable surgery, you may wish to discuss the option of Viscosupplementation with your orthopedic doctor.
Diagnosing and Treating Osteoarthritis of the Knees
Osteoarthritis of the knee has a tremendous impact on a patient's
ability to function in routine daily activities. According to the
American Academy of Orthopedic Surgeons, over 13 million adults in the
U.S. presented with OA symptoms in 2001. The majority of these patients
were senior adults.
Pain, swelling and stiffness are the most common symptoms associated with OA of the knee. These symptoms limit the patient's ability to bend or straighten the knee, and they may also feel grinding, popping, locking, or giving way.
Dr. Harry Derderian, an orthopedic surgeon at Lexington Clinic East in Lexington, Kentucky, specializes in both hip and knee replacement surgeries. As one of Dr. Derderian's clinical assistants, I have seen many patients suffering from the effects of OA.
When patients are initially seen in consultation for knee pain, Dr. Derderian uses the following protocol for diagnosing and treating OA of the knee:
1. X-rays of the knees are taken to look for characteristics of OA, such as bone spurs or joint space narrowing. Normal cartilage appears as a "gap" between the thigh (femur) and lower leg (tibia) bone. Advanced OA of the knee shows a "bone on bone" appearance on x-ray.
2. Physical examination of both knees includes evaluating and comparing the patient's range of motion in each knee. Dr. Derderian also determines if a patient is experiencing swelling (effusion) of the knee joints. He then checks for points of maximum tenderness along the medial (inside of the knee) joint lines and lateral (outside of the knee) joint lines.
Grinding (crepetation) occurs when the patient's knee is flexed or extended. This is most commonly due to chondromalacia patella (wear and tear underneath the kneecap).
3. In addition to conventional x-rays and physical examination, an MRI of the knee may be ordered to look for tears of the meniscus, the C-shaped, shock-absorbing cushion.
After a diagnosis of OA of the knee is made, an appropriate treatment plan is determined. A general protocol is followed which varies according to the health and needs of the patient.
4. Physical therapy may be instituted for a period of one month in hopes of alleviating symptoms by strengthening the quadriceps muscles of the thighs which would help take pressure off the knees. The therapist may also use other modalities at their discretion, such as heat or ultrasound.
5. If physical therapy does not improve the patient's symptoms, the physician may opt to drain any excess fluid from the knee joint and begin cortisone injections if the patient meets appropriate criteria.
6. The patient may need to modify activity levels or work with restrictions until symptoms improve. Losing weight is also a recommendation if the patient is overweight. For every pound of body fat lost, four pounds of pressure is taken off the knees!
In certain cases, a supplemental lubricant called Synvisc may be injected in place of the cortisone therapy. This lubricant is injected on a weekly basis for three consecutive weeks.
A total knee replacement may be warranted if the patient has advanced OA of the knee.
Many considerations are taken prior to scheduling a patient for this surgery, such as the patient's general health, if they will have assistance following surgery, and other individual factors.
If the physician and patient both agree to pursue a total knee replacement, the patient will be scheduled for the following:
*Joint replacement class at the hospital to inform the patient about the procedure and what to expect following surgery.
*Pre-op physical with the primary care physician.
*A pre-op appointment with Orthopedics the week prior to surgery.
Currently, Dr. Derderian uses hardware which includes a:
*Femoral component, made of cobalt chrome metal,
*Tibial component, made of a durable plastic positioned in a metal tray, and a
*Patellar component, also plastic.
An average hospital stay is three days, but may vary depending on the patient. A "cell saver" unit is used to reduce the need for blood transfusions. If a patient has help, they may be discharged home. Otherwise, the patient may be admitted to a rehabilitation facility for several days following discharge from the hospital.
A patient is generally placed on anti-coagulant therapy to help prevent the formation of blood clots in the leg, which is a risk following surgery. Lovenox injections may be prescribed post-operatively for 7-10 days to prevent clotting.
Staples at the incision site are generally removed after a period of 10-14 days.
Physical therapy will be instituted soon after discharge, initially done at home by a visiting therapist, then progressing to outpatient treatment at a physical therapy facility of choice. The main goal is to achieve optimal flexion and extension following a knee replacement.
A "new knee" will not be a "normal knee". Hopefully, the knee replacement will resolve a majority of the pain and disability felt prior to surgery; however, there is no guarantee.
In conclusion, OA of the knee is a potentially disabling diagnosis but treatment is available to help many patients.
Pain, swelling and stiffness are the most common symptoms associated with OA of the knee. These symptoms limit the patient's ability to bend or straighten the knee, and they may also feel grinding, popping, locking, or giving way.
Dr. Harry Derderian, an orthopedic surgeon at Lexington Clinic East in Lexington, Kentucky, specializes in both hip and knee replacement surgeries. As one of Dr. Derderian's clinical assistants, I have seen many patients suffering from the effects of OA.
When patients are initially seen in consultation for knee pain, Dr. Derderian uses the following protocol for diagnosing and treating OA of the knee:
1. X-rays of the knees are taken to look for characteristics of OA, such as bone spurs or joint space narrowing. Normal cartilage appears as a "gap" between the thigh (femur) and lower leg (tibia) bone. Advanced OA of the knee shows a "bone on bone" appearance on x-ray.
2. Physical examination of both knees includes evaluating and comparing the patient's range of motion in each knee. Dr. Derderian also determines if a patient is experiencing swelling (effusion) of the knee joints. He then checks for points of maximum tenderness along the medial (inside of the knee) joint lines and lateral (outside of the knee) joint lines.
Grinding (crepetation) occurs when the patient's knee is flexed or extended. This is most commonly due to chondromalacia patella (wear and tear underneath the kneecap).
3. In addition to conventional x-rays and physical examination, an MRI of the knee may be ordered to look for tears of the meniscus, the C-shaped, shock-absorbing cushion.
After a diagnosis of OA of the knee is made, an appropriate treatment plan is determined. A general protocol is followed which varies according to the health and needs of the patient.
4. Physical therapy may be instituted for a period of one month in hopes of alleviating symptoms by strengthening the quadriceps muscles of the thighs which would help take pressure off the knees. The therapist may also use other modalities at their discretion, such as heat or ultrasound.
5. If physical therapy does not improve the patient's symptoms, the physician may opt to drain any excess fluid from the knee joint and begin cortisone injections if the patient meets appropriate criteria.
6. The patient may need to modify activity levels or work with restrictions until symptoms improve. Losing weight is also a recommendation if the patient is overweight. For every pound of body fat lost, four pounds of pressure is taken off the knees!
In certain cases, a supplemental lubricant called Synvisc may be injected in place of the cortisone therapy. This lubricant is injected on a weekly basis for three consecutive weeks.
A total knee replacement may be warranted if the patient has advanced OA of the knee.
Many considerations are taken prior to scheduling a patient for this surgery, such as the patient's general health, if they will have assistance following surgery, and other individual factors.
If the physician and patient both agree to pursue a total knee replacement, the patient will be scheduled for the following:
*Joint replacement class at the hospital to inform the patient about the procedure and what to expect following surgery.
*Pre-op physical with the primary care physician.
*A pre-op appointment with Orthopedics the week prior to surgery.
Currently, Dr. Derderian uses hardware which includes a:
*Femoral component, made of cobalt chrome metal,
*Tibial component, made of a durable plastic positioned in a metal tray, and a
*Patellar component, also plastic.
An average hospital stay is three days, but may vary depending on the patient. A "cell saver" unit is used to reduce the need for blood transfusions. If a patient has help, they may be discharged home. Otherwise, the patient may be admitted to a rehabilitation facility for several days following discharge from the hospital.
A patient is generally placed on anti-coagulant therapy to help prevent the formation of blood clots in the leg, which is a risk following surgery. Lovenox injections may be prescribed post-operatively for 7-10 days to prevent clotting.
Staples at the incision site are generally removed after a period of 10-14 days.
Physical therapy will be instituted soon after discharge, initially done at home by a visiting therapist, then progressing to outpatient treatment at a physical therapy facility of choice. The main goal is to achieve optimal flexion and extension following a knee replacement.
A "new knee" will not be a "normal knee". Hopefully, the knee replacement will resolve a majority of the pain and disability felt prior to surgery; however, there is no guarantee.
In conclusion, OA of the knee is a potentially disabling diagnosis but treatment is available to help many patients.
How to Choose a Knee Brace
When choosing a knee brace, there are several factors to take into
consideration, the first being what type of injury you have. This is
important as the right brace makes all the difference in a bad injury.
Here is a breakdown of different braces and what they might be used for.
Be sure to seek a doctor's advice before buying a new knee brace to
ensure you're buying a knee brace that is right for your injury.
Hinged braces
Hinged braces are considered more heavy duty and usually provide more support and stability than neoprene or elastic braces. Hinged braces facilitate movement and are mostly used for people with lateral or medial instability of the knee (medial refers to the inner side of the knee joint; lateral refers to the outside of the knee joint), and people with ACL (anterior cruciate ligament) injuries.
The ACL is one of the main stabilizing ligaments in the knee. Resulting from hyperextension of the knee or a blow, injury to the ACL can be partial or complete. In addition to ACL, hinged knee braces also help with PCL (posterior cruciate ligament) injuries, another major ligament of the knee that works with the ACL and is very important to the function of the knee.
Neoprene Braces
Neoprene is widely used in many products, and is known for its high insulation and heat retention properties. Neoprene knee braces are great because they stretch in all four directions, maintain their shape, and don't bunch up at the knee.
A durable material, neoprene lasts a long time and is great for cold weather conditions; many people use this brace in colder conditions for activities like snowboarding, ice skating, and even runs and walks to keep their knee warm and keep the blood circulating.
Pediatric Knee Braces
Pediatric knee braces are those that are used specifically for youth. They generally allow a wide range of flexibility, and thus are an excellent choice for use with injuries of growing joints and ligaments in children and youth.
Elastic Braces
Elastic braces are generally made of stretchable, breathable fibers that provide maximum comfort for the wearer. They are widely used for support of the knee joint, even if no injury has occurred. They are best for light, non-serious injuries and are great for non-injured support of the knee as well.
Knee Bands
Knee bands are used to relieve knee stress resulting from a number of knee conditions, including Osgood Schlatters disease and Patella Tendonitis (runners or jumper's knee), and a number of other knee conditions. Knee bands can also be used to support and improve circulation in the knee, even if you aren't injured.
Professional Knee Braces
Professional Knee braces are used in severe cases of knee injury where the patient has received surgery or has been immobilized for a long period of time. The professional knee braces are constructed of metal, usually aluminum, and provide maximum stability and support for the knee. They are longer, stronger, and offer the most support of all the braces.
Arthritis Braces
Arthritis braces serve to relieve the pain and stress of arthritic knee joints. The pain and restricted motion from an arthritic knee is somewhat balanced by an arthritic knee brace because it changes the angle of your knee joint with special hinges, reducing the pressure on the joint.
Post-Operative Knee Braces
Post-Operative knee braces are used after an injury or a surgery. They provide limited motion in the initial healing stages, and progressively allow for a fuller ranger of motion. Post- Operative Knee Braces are usually adjustable, and most have hinges to control the directions you can move your leg and the length you can extend it out.
Hinged braces
Hinged braces are considered more heavy duty and usually provide more support and stability than neoprene or elastic braces. Hinged braces facilitate movement and are mostly used for people with lateral or medial instability of the knee (medial refers to the inner side of the knee joint; lateral refers to the outside of the knee joint), and people with ACL (anterior cruciate ligament) injuries.
The ACL is one of the main stabilizing ligaments in the knee. Resulting from hyperextension of the knee or a blow, injury to the ACL can be partial or complete. In addition to ACL, hinged knee braces also help with PCL (posterior cruciate ligament) injuries, another major ligament of the knee that works with the ACL and is very important to the function of the knee.
Neoprene Braces
Neoprene is widely used in many products, and is known for its high insulation and heat retention properties. Neoprene knee braces are great because they stretch in all four directions, maintain their shape, and don't bunch up at the knee.
A durable material, neoprene lasts a long time and is great for cold weather conditions; many people use this brace in colder conditions for activities like snowboarding, ice skating, and even runs and walks to keep their knee warm and keep the blood circulating.
Pediatric Knee Braces
Pediatric knee braces are those that are used specifically for youth. They generally allow a wide range of flexibility, and thus are an excellent choice for use with injuries of growing joints and ligaments in children and youth.
Elastic Braces
Elastic braces are generally made of stretchable, breathable fibers that provide maximum comfort for the wearer. They are widely used for support of the knee joint, even if no injury has occurred. They are best for light, non-serious injuries and are great for non-injured support of the knee as well.
Knee Bands
Knee bands are used to relieve knee stress resulting from a number of knee conditions, including Osgood Schlatters disease and Patella Tendonitis (runners or jumper's knee), and a number of other knee conditions. Knee bands can also be used to support and improve circulation in the knee, even if you aren't injured.
Professional Knee Braces
Professional Knee braces are used in severe cases of knee injury where the patient has received surgery or has been immobilized for a long period of time. The professional knee braces are constructed of metal, usually aluminum, and provide maximum stability and support for the knee. They are longer, stronger, and offer the most support of all the braces.
Arthritis Braces
Arthritis braces serve to relieve the pain and stress of arthritic knee joints. The pain and restricted motion from an arthritic knee is somewhat balanced by an arthritic knee brace because it changes the angle of your knee joint with special hinges, reducing the pressure on the joint.
Post-Operative Knee Braces
Post-Operative knee braces are used after an injury or a surgery. They provide limited motion in the initial healing stages, and progressively allow for a fuller ranger of motion. Post- Operative Knee Braces are usually adjustable, and most have hinges to control the directions you can move your leg and the length you can extend it out.
Osgood Slaughter Disease: Growing Pains in the Knees
Many years ago when my daughter was about 12, and was growing quite
tall, she began to complain of knee pain. She was a very active athlete
and played basketball, volleyball
and softball. She had been a pitcher for several years and the pain
began one summer during fastpitch softball. At a trip to see the doctor,
we learned she had Osgood Slaughter
Disease. I had never heard of the condition at that time, but through
the years, I began hearing more about it, mainly because both boys and
girls were beginning to be in many more sports.
Osgood Slaughter Disease is the inflammation of the patellar tendon where the knee meets the top of the tibia (shinbone). The condition is caused by stress on the tendon that attaches the muscle at the front of the thigh to the tibia. It is probably caused by the powerful quadriceps muscle pulling on the attachment point of the patellar tendon during running activities such as soccer, basketball, track and other sports and in gymnastics and ballet.
The symptoms associated with Osgood Slaughter Disease is swelling and tenderness in the knee joint. It is most common in active children aged 10-15. It is the most common source of knee pain in children. Both males and females are equally vulnerable now, but at one time, the condition was found mainly in boys. It is always characterized by activity-related pain that is located a few inches below the knee cap. Sports that require a lot of running, jumping kneeling and squatting are particularly associated with Osgood Slaughter Disease.
The three main factors of the disease are:
1. The child is between 10 and 15 years old
2. The child is involved in youth sports
3. The child is in a 'growth spurt'
In a Finnish research study, it was found that 13% of the teenagers in Finland had symptoms of Osgood-Slaughter Disease. The disease was named after two physicians who defined the disease in 1903. About 2 million boys and girls in the United States contract Osgood-Slaughter Disease yearly.
Until recently, the only treatment for Osgood-Slaughter Disease was anti-inflammatory drugs in conjunction with rest, ice, compression bandage (elastic bandage), and elevation of the affected leg. This treatment is known as "RICE". Now, a new product called Oscon is being used and it appears to work on a variety of levels to treat the condition. People are also using over-the-counter remedies such as glucosamine, MSM, chondroitin and selenium with very good results. Pain relievers such as aspirin or ibuprofen (Advil, Motrin) may reduce the pain and swelling.
To treat Osgood-Slaughter Disease, your child's doctor may suggest that he or she cut down on time spent playing sports until the pain has been gone for 2 to 4 months. Some physicians recommend the basic treatment "RICE", or even the use of a brace that will reduce tension on the patellar tendons and quadriceps.
One preventative measure, that may help the disease from happening again, is exercises to strengthen the quadriceps and hamstring muscles. Your doctor may prescribe exercises such as straight-leg raises, leg curls and quadriceps contractions for your child to do at home to help prevent further problems.
In some cases, if the child ignores the pain and plays through it, the disease may get worse and may be more difficult to treat. Only rarely, Osgood Slaughter Disease persists beyond the growth stage and in most people, Osgood-Slaughter Disease goes away on its own with rest and time.
Osgood Slaughter Disease is the inflammation of the patellar tendon where the knee meets the top of the tibia (shinbone). The condition is caused by stress on the tendon that attaches the muscle at the front of the thigh to the tibia. It is probably caused by the powerful quadriceps muscle pulling on the attachment point of the patellar tendon during running activities such as soccer, basketball, track and other sports and in gymnastics and ballet.
The symptoms associated with Osgood Slaughter Disease is swelling and tenderness in the knee joint. It is most common in active children aged 10-15. It is the most common source of knee pain in children. Both males and females are equally vulnerable now, but at one time, the condition was found mainly in boys. It is always characterized by activity-related pain that is located a few inches below the knee cap. Sports that require a lot of running, jumping kneeling and squatting are particularly associated with Osgood Slaughter Disease.
The three main factors of the disease are:
1. The child is between 10 and 15 years old
2. The child is involved in youth sports
3. The child is in a 'growth spurt'
In a Finnish research study, it was found that 13% of the teenagers in Finland had symptoms of Osgood-Slaughter Disease. The disease was named after two physicians who defined the disease in 1903. About 2 million boys and girls in the United States contract Osgood-Slaughter Disease yearly.
Until recently, the only treatment for Osgood-Slaughter Disease was anti-inflammatory drugs in conjunction with rest, ice, compression bandage (elastic bandage), and elevation of the affected leg. This treatment is known as "RICE". Now, a new product called Oscon is being used and it appears to work on a variety of levels to treat the condition. People are also using over-the-counter remedies such as glucosamine, MSM, chondroitin and selenium with very good results. Pain relievers such as aspirin or ibuprofen (Advil, Motrin) may reduce the pain and swelling.
To treat Osgood-Slaughter Disease, your child's doctor may suggest that he or she cut down on time spent playing sports until the pain has been gone for 2 to 4 months. Some physicians recommend the basic treatment "RICE", or even the use of a brace that will reduce tension on the patellar tendons and quadriceps.
One preventative measure, that may help the disease from happening again, is exercises to strengthen the quadriceps and hamstring muscles. Your doctor may prescribe exercises such as straight-leg raises, leg curls and quadriceps contractions for your child to do at home to help prevent further problems.
In some cases, if the child ignores the pain and plays through it, the disease may get worse and may be more difficult to treat. Only rarely, Osgood Slaughter Disease persists beyond the growth stage and in most people, Osgood-Slaughter Disease goes away on its own with rest and time.
Yoga Asana Sequence to Heal Knee Pain
Ah, the knee! Such a complex & delicate thing ~ and such a range of
accidents, injuries, abuses/misfortunes of all sorts, it is subjected
to. Whether you're a basketball player or skier with a torn ACL or
medial meniscus; a distance runner beginning to feel a bit of arthritic
in your knees; someone who's contemplating arthroscopic surgery to
diagnose an unidentified pain in your knees; or simply tolerating
stiffness and swelling (which could indicate Chondromalacia Patellae,
among other things); know that you are not alone! Millions suffer from
knee pain of one kind or another: of some infringement of bone,
cartilage, muscle or ligament, creating various forms of bursitis,
arthritis, cysts, and tears, to name the most common of "knee pain"
diagnoses. The GOOD NEWS is that your treatment options are many, and
the prognosis for partial or full recovery very good. As you research
these options, consider a therapeutic Yoga practice as an excellent
adjunct (and a way, after you've recovered, of maintaining your knees in
their new & healthy state). An intelligently applied sequence of
Yoga asanas, performed under the guidance of a qualified instructor, can
be a powerfully effective tool for rehabilitating injured knees: for
building strength, flexibility & intelligence in this most delicate
joint.
Yoga In Context
The term "Ashtanga Yoga" has in recent years become associated largely with the Ashtanga vinyasa form of Hatha Yoga, originated by Krishnamacharya, transmitted to K. Patabhi Jois, and offered now to Western students by well-known teachers such as Tim Miller, Richard Freeman and Eddie Stern. This latter system is characterized by the interlinking (vinyasa), via sun salutation movements, of particular sequences of asanas. The system is composed of seven distinct series, each defined by its own set of asanas, and designed to accomplish a specific goal (e.g. to purify apana, or to cleanse the nadis).
More universally (i.e. in terms of the Six Yogas System), Ashtanga Yoga refers to the eight limbs ("Ashta"=eight, "anga"=limb) of Raja Yoga ("Raja"=royal, "Yoga"=union), which define a path of spiritual liberation (the permanent release from all forms of suffering when the small self of ego is yoked or joined to the Self of Spirit/Pure Consciousness). The Ashtanga vinyasa system belongs to the third of these eight limbs (asana). Traditionally, one did not embark upon an asana practice until their foundation in the first two limbs was firmly established. Also traditional was to use asana practice primarily as a tool for making the body more comfortable when practicing sitting meditation. It has only been in recent years that asana practice in and of itself has been developed as a path through which the other seven limbs of this system might be practiced and refined. The eight limbs of Raja/Ashtanga Yoga are, in brief:
1. Yamas, or Restraints (harmlessness, truthfulness, non-stealing, control of senses)
2. Niyamas, or Disciplines (cleanliness, purification of body, mind and nervous system, study of metaphysical principles, contemplation on God)
3. Asanas or Postures
4. Pranayama, or Un-binding of breath and life-currents
5. Pratyahara, or Turning the attention within, by reversing the flow of the energy of the sense organs
6. Dharana, or Concentration
7. Dhyana, or Meditation, i.e. prolonged periods of perfect concentration and contemplation
8. Samadhi, or Mystical Union
What becomes immediately evident from this listing of the eight limbs of Ashtanga Yoga, is that the terrain of Yoga, at least potentially, is so much more vast than that of simply the physical body. This point becomes even more clear via this passage from the sixth chapter of the Bhagavad Gita, in which Shri Krishna explains to Arjuna the meaning of Yoga:
"When his mind, intellect and self (ahamkara) are under control, freed from restless desire, so that they rest in the spirit within, a man becomes a Yukta - one in communion with God. A lamp does not flicker in a place where no winds blow; so it is with a yogi, who controls his mind, intellect and self, being absorbed in the spirit within him. When the restlessness of the mind, intellect and self is stilled through the practice of Yoga, the yogi by the grace of the Spirit within himself finds fulfillment. Then he knows the joy eternal which is beyond the pale of the senses which his reason cannot grasp. He abides in this reality and moves not therefrom. He has found the treasure above all others. There is nothing higher than this. He who has achieved it, shall not be moved by the greatest sorrow. This is the real meaning of Yoga - a deliverance from contact with pain and sorrow."
Yet to say that the potential of Yoga is freedom from all (physical, mental, emotional, psychological, psychic) pain and sorrow, is not to deny nor belittle its power to re-balance, strengthen and heal the physical body. Such work, in fact, is often foundational for entering into the more subtle aspects of the practice. And what could be wrong with enjoying radiant good health, freedom from pain, boundless energy, and a felt sense of joy, clarity and relaxation?!
Certain communities of practitioners have developed to a fine art and sophisticated science the use of yoga asana to heal the body. For instance: at the same time that K.Patabhi Jois has been offering to the yoga world the Ashtanga vinyasa system, another student of Krishnamacharya ~ B.K.S. Iyengar ~ has developed an equally powerful approach to asana practice, one of whose strong points is its therapeutic applications. Through Mr. Iyengar's own teaching, as well as that of thousands of certified Iyengar instructors, countless numbers of students have reaped the benefits ~ in terms of relief from chronic and acute conditions of all sorts ~ of this system of working with the yoga asanas. Gleaned from the many years of his practice & teaching, Mr. Iyengar now is able to offer (and has generously listed, in the appendix to his book "Light On Yoga") sequences of specific poses designed to alleviate particular conditions.
The poses (and pranayamas) recommended to heal knee pain & then to maintain healthy knees include:
•All the standing positions
•Janu-Sirsasana
•Parivrtta Janu-Sirsasana
•Ardha Baddha Padma Paschimottanasana
•Marichyasana I, II, III & IV
•Akarna Dhanurasana
•Padmasana & cycle
•Virasana
•Supta Virasana
•Paryankasana
•Gomukhasana
•Siddhasana
•Baddha Konasana
•Bharadwajasana I & II
•Ardha Matsyendrasana I
•Malasana I & II
•Pasasana
•Kurmasana & Supta Kurmasana
•Yogadandasana
•Bhekasana
•Supta Bhekhasana
•Mulabandhasana
•Vamevasana I & II
•Kandasana
•Hanumanasana
•Gherandasana I & II
For maximum benefit, this sequence (or some portion of it) should be practiced on a regular basis, and under the guidance of a qualified Yoga instructor ~ someone who will be able to guide you safely into and out of the asanas, modifying them according to your own unique physical condition and abilities.
Yoga In Context
The term "Ashtanga Yoga" has in recent years become associated largely with the Ashtanga vinyasa form of Hatha Yoga, originated by Krishnamacharya, transmitted to K. Patabhi Jois, and offered now to Western students by well-known teachers such as Tim Miller, Richard Freeman and Eddie Stern. This latter system is characterized by the interlinking (vinyasa), via sun salutation movements, of particular sequences of asanas. The system is composed of seven distinct series, each defined by its own set of asanas, and designed to accomplish a specific goal (e.g. to purify apana, or to cleanse the nadis).
More universally (i.e. in terms of the Six Yogas System), Ashtanga Yoga refers to the eight limbs ("Ashta"=eight, "anga"=limb) of Raja Yoga ("Raja"=royal, "Yoga"=union), which define a path of spiritual liberation (the permanent release from all forms of suffering when the small self of ego is yoked or joined to the Self of Spirit/Pure Consciousness). The Ashtanga vinyasa system belongs to the third of these eight limbs (asana). Traditionally, one did not embark upon an asana practice until their foundation in the first two limbs was firmly established. Also traditional was to use asana practice primarily as a tool for making the body more comfortable when practicing sitting meditation. It has only been in recent years that asana practice in and of itself has been developed as a path through which the other seven limbs of this system might be practiced and refined. The eight limbs of Raja/Ashtanga Yoga are, in brief:
1. Yamas, or Restraints (harmlessness, truthfulness, non-stealing, control of senses)
2. Niyamas, or Disciplines (cleanliness, purification of body, mind and nervous system, study of metaphysical principles, contemplation on God)
3. Asanas or Postures
4. Pranayama, or Un-binding of breath and life-currents
5. Pratyahara, or Turning the attention within, by reversing the flow of the energy of the sense organs
6. Dharana, or Concentration
7. Dhyana, or Meditation, i.e. prolonged periods of perfect concentration and contemplation
8. Samadhi, or Mystical Union
What becomes immediately evident from this listing of the eight limbs of Ashtanga Yoga, is that the terrain of Yoga, at least potentially, is so much more vast than that of simply the physical body. This point becomes even more clear via this passage from the sixth chapter of the Bhagavad Gita, in which Shri Krishna explains to Arjuna the meaning of Yoga:
"When his mind, intellect and self (ahamkara) are under control, freed from restless desire, so that they rest in the spirit within, a man becomes a Yukta - one in communion with God. A lamp does not flicker in a place where no winds blow; so it is with a yogi, who controls his mind, intellect and self, being absorbed in the spirit within him. When the restlessness of the mind, intellect and self is stilled through the practice of Yoga, the yogi by the grace of the Spirit within himself finds fulfillment. Then he knows the joy eternal which is beyond the pale of the senses which his reason cannot grasp. He abides in this reality and moves not therefrom. He has found the treasure above all others. There is nothing higher than this. He who has achieved it, shall not be moved by the greatest sorrow. This is the real meaning of Yoga - a deliverance from contact with pain and sorrow."
Yet to say that the potential of Yoga is freedom from all (physical, mental, emotional, psychological, psychic) pain and sorrow, is not to deny nor belittle its power to re-balance, strengthen and heal the physical body. Such work, in fact, is often foundational for entering into the more subtle aspects of the practice. And what could be wrong with enjoying radiant good health, freedom from pain, boundless energy, and a felt sense of joy, clarity and relaxation?!
Certain communities of practitioners have developed to a fine art and sophisticated science the use of yoga asana to heal the body. For instance: at the same time that K.Patabhi Jois has been offering to the yoga world the Ashtanga vinyasa system, another student of Krishnamacharya ~ B.K.S. Iyengar ~ has developed an equally powerful approach to asana practice, one of whose strong points is its therapeutic applications. Through Mr. Iyengar's own teaching, as well as that of thousands of certified Iyengar instructors, countless numbers of students have reaped the benefits ~ in terms of relief from chronic and acute conditions of all sorts ~ of this system of working with the yoga asanas. Gleaned from the many years of his practice & teaching, Mr. Iyengar now is able to offer (and has generously listed, in the appendix to his book "Light On Yoga") sequences of specific poses designed to alleviate particular conditions.
The poses (and pranayamas) recommended to heal knee pain & then to maintain healthy knees include:
•All the standing positions
•Janu-Sirsasana
•Parivrtta Janu-Sirsasana
•Ardha Baddha Padma Paschimottanasana
•Marichyasana I, II, III & IV
•Akarna Dhanurasana
•Padmasana & cycle
•Virasana
•Supta Virasana
•Paryankasana
•Gomukhasana
•Siddhasana
•Baddha Konasana
•Bharadwajasana I & II
•Ardha Matsyendrasana I
•Malasana I & II
•Pasasana
•Kurmasana & Supta Kurmasana
•Yogadandasana
•Bhekasana
•Supta Bhekhasana
•Mulabandhasana
•Vamevasana I & II
•Kandasana
•Hanumanasana
•Gherandasana I & II
For maximum benefit, this sequence (or some portion of it) should be practiced on a regular basis, and under the guidance of a qualified Yoga instructor ~ someone who will be able to guide you safely into and out of the asanas, modifying them according to your own unique physical condition and abilities.
Knee Pain: Is Arthroscopic Surgery for You?
Knee pain may be the result of a variety of causes, from an accident to
arthritis. Whatever the reason for knee pain, surgery is always the last
option. An off-the-record definition for surgery has been described by
some as 'scheduled trauma'. However, if knees continue to cause pain or
to hinder daily life, arthroscopic surgery may be necessary. Know the
facts before invading the body's natural ability to heal.
The first course of action with knee pain is to reduce inflammation, which is usually the cause of pain due to overuse. Athletes struggle with this. The good old-fashioned ice pack is known to work wonders. If running, biking, or even walking causes swelling or pain, simply apply an ice pack immediately after the activity. Friction in the knee joint causes blood to gather around the joint; ice reduces the amount of blood to the area, giving the knee a chance to get back to normal operating procedure. Remember to apply ice only in 20 minute increments with a 20 minute relief in between. Many pharmacies carry ice packs that strap around the knee for under $15 dollars, a small price to pay for repeated relief.
In more serious cases, a ligament (along the side of the knee) may be strained, or the meniscus torn. The meniscus is the padding between the thigh bone (femur) and the shin bone (tibia). While a strained ligament can be quite painful; it does not require surgery. However, a torn meniscus usually gets worse rather than better because it's in a frequent movement area that has applied pressure. Arthroscopic surgery may be recommended by an orthopedist, or sports medicine physician.
What happens after the diagnosis?
When a physician has determined that surgery is the best option for knee pain, the preparation for surgery is the same as any other day surgery. There should be no eating or drinking after midnight before the surgery. Surgeons usually like to take small children earlier in the morning, so be prepared to wait up until 11:00am in some cases. Prepared patients are sent to a surgical waiting area where an anesthesiologist will usually appear to explain his or her job to you. This can be a very peaceful experience when the patient is relaxed and confident.
How is the surgery performed?
When the patient is fully anesthetized, the doctor makes three small incisions in the around the kneecap. Each incision is for a specific instrument; one is for the light, one is to pump air, and the other is to repair the damaged area. The knee cap is raised out of its position and the area beneath is carefully repaired and cleaned. Sometimes, excess cartilage is cleaned away from behind the knee cap from the build-up of arthritis. To prevent further build-up after surgery - believe it or not - frequent movement is the remedy. Arthritis occurs when joints are stiffened and not moved. Walking is the best movement; it is low impact on the knee, but good for circulation and minimal movement of the knee.
What is recovery like?
Recovery from arthroscopic knee surgery is remarkably fast. Depending on the amount of work done to the knee, the doctor may opt to wrap the knee and have the patient gently walk out of the hospital. Of course bed rest is recommended, but frequent and immediate movement to prevent stiffening is usually the doctors' orders. Although there is some swelling from the surgery, and a bit of discomfort from the incisions, the relief from knee pain is immediate. The doctor or attending nurse will send home instructions for each particular case, but most are common with 20 minute intervals of icing and perhaps an anti-inflammatory or mild pain reliever. Another important part of recovery is to follow the doctors' instructions for exercise. Simple, non-strenuous exercises will help the area to heal well.
What kind of medications will be prescribed?
Immediately after surgery, if the patient is experiencing and undue amount of pain, the doctor will prescribe a moderate pain reliever like Vicodin or Percocet. Different pain medications have different base ingredients - Vicodin has hydrocodone and the base in Percocet is oxycodone; both medications are narcotic and both medications also are combined with acetaminophen. This is why doctors and nurses need to know patients' allergies to medications. Usually, a day or two of one of these medications is sufficient; afterwards, Tylenol works fine. Most often, a regimen of anti-inflammatory medication will be given over a period of a few months to keep the swelling down while the knee completely recovers.
While surgery is always the last option for treatment in any medical condition, it is an option. If trying every other method to relieve pain is ineffective, or pain and swelling increase and persist, or if pain is at a level that wakes the patient in the night, it may be time to consult a sports medicine physician. Recuperation time is minimal and relief is almost immediate. Scheduling surgery over a long weekend or close to a secondary holiday is sometimes advised to get the extra day of rest. Whatever the decision, always follow the advice given by your doctor.
The first course of action with knee pain is to reduce inflammation, which is usually the cause of pain due to overuse. Athletes struggle with this. The good old-fashioned ice pack is known to work wonders. If running, biking, or even walking causes swelling or pain, simply apply an ice pack immediately after the activity. Friction in the knee joint causes blood to gather around the joint; ice reduces the amount of blood to the area, giving the knee a chance to get back to normal operating procedure. Remember to apply ice only in 20 minute increments with a 20 minute relief in between. Many pharmacies carry ice packs that strap around the knee for under $15 dollars, a small price to pay for repeated relief.
In more serious cases, a ligament (along the side of the knee) may be strained, or the meniscus torn. The meniscus is the padding between the thigh bone (femur) and the shin bone (tibia). While a strained ligament can be quite painful; it does not require surgery. However, a torn meniscus usually gets worse rather than better because it's in a frequent movement area that has applied pressure. Arthroscopic surgery may be recommended by an orthopedist, or sports medicine physician.
What happens after the diagnosis?
When a physician has determined that surgery is the best option for knee pain, the preparation for surgery is the same as any other day surgery. There should be no eating or drinking after midnight before the surgery. Surgeons usually like to take small children earlier in the morning, so be prepared to wait up until 11:00am in some cases. Prepared patients are sent to a surgical waiting area where an anesthesiologist will usually appear to explain his or her job to you. This can be a very peaceful experience when the patient is relaxed and confident.
How is the surgery performed?
When the patient is fully anesthetized, the doctor makes three small incisions in the around the kneecap. Each incision is for a specific instrument; one is for the light, one is to pump air, and the other is to repair the damaged area. The knee cap is raised out of its position and the area beneath is carefully repaired and cleaned. Sometimes, excess cartilage is cleaned away from behind the knee cap from the build-up of arthritis. To prevent further build-up after surgery - believe it or not - frequent movement is the remedy. Arthritis occurs when joints are stiffened and not moved. Walking is the best movement; it is low impact on the knee, but good for circulation and minimal movement of the knee.
What is recovery like?
Recovery from arthroscopic knee surgery is remarkably fast. Depending on the amount of work done to the knee, the doctor may opt to wrap the knee and have the patient gently walk out of the hospital. Of course bed rest is recommended, but frequent and immediate movement to prevent stiffening is usually the doctors' orders. Although there is some swelling from the surgery, and a bit of discomfort from the incisions, the relief from knee pain is immediate. The doctor or attending nurse will send home instructions for each particular case, but most are common with 20 minute intervals of icing and perhaps an anti-inflammatory or mild pain reliever. Another important part of recovery is to follow the doctors' instructions for exercise. Simple, non-strenuous exercises will help the area to heal well.
What kind of medications will be prescribed?
Immediately after surgery, if the patient is experiencing and undue amount of pain, the doctor will prescribe a moderate pain reliever like Vicodin or Percocet. Different pain medications have different base ingredients - Vicodin has hydrocodone and the base in Percocet is oxycodone; both medications are narcotic and both medications also are combined with acetaminophen. This is why doctors and nurses need to know patients' allergies to medications. Usually, a day or two of one of these medications is sufficient; afterwards, Tylenol works fine. Most often, a regimen of anti-inflammatory medication will be given over a period of a few months to keep the swelling down while the knee completely recovers.
While surgery is always the last option for treatment in any medical condition, it is an option. If trying every other method to relieve pain is ineffective, or pain and swelling increase and persist, or if pain is at a level that wakes the patient in the night, it may be time to consult a sports medicine physician. Recuperation time is minimal and relief is almost immediate. Scheduling surgery over a long weekend or close to a secondary holiday is sometimes advised to get the extra day of rest. Whatever the decision, always follow the advice given by your doctor.
Overcoming Chronic Pain Through Hypnosis
I feel like an advertisement for hypnosis when I tell my chronic pain
story, but if it helps one person gain relief from chronic pain, it is a
story worth telling. I never believed in hypnosis until I was in
college. I didn't try hypnosis for chronic pain relief at that time. It
was recommended by a friend that I try it for stress management. Much to
my surprise, the hypnosis worked. I didn't cluck like a chicken, and I
remembered the whole process. What the hypnosis did do was give me
relaxation practices to help me cope with my stress.
Years down the road I found myself a patient repeatedly visiting doctors' offices for chronic back pain. I did not want to undergo surgery of any kind, but chronic pain management through medication was not working. At least, it was not working well enough. When one doctor suggested I try hypnosis to help ease my chronic pain, I was on board from the get go. I am sure, had I not had the positive past experience, I would have been more than hesitant to try it out.
I started hypnosis therapy for my chronic pain in June. By August I was feeling some relief from the chronic back pain. Through hypnosis therapy, I was able to learn to embrace the chronic pain and teach my body to accept it. I found that the more my body fought the pain, the more chronic back pain I felt. Through hypnosis I learned more relaxation techniques, not so different from the stress relievers I needed in my college days. I also learned to take care of my body in general better. All of this, combined with my medication, has helped manage my chronic pain. Through the use of hypnosis, I was able to stay out of the hospital, and I only go to the doctor's office for regular check-ups now, not for chronic pain complaints.
Granted, my story of beating chronic pain through hypnosis is one of success. Hypnosis does not work for everyone, especially anyone who is overtly skeptical of the practice. Non-believers, as I like to call them, are less receptive to the power of suggestion used during hypnosis. Again, no one suggests you cluck like a chicken, but the strategies of relaxation are channeled through suggestion. Similarly, individuals who are skeptical of hypnosis to cure their chronic pain tend to be tense during the hypnosis. Again, the hypnosis will not work. I have been told that with repeated sessions, some non-believers can even begin to feel relief as they begin to relax within the treatments.
All I know is I don't classify myself as a person with chronic backpains anymore. I don't limit myself or because of possible chronic pain or flare-ups. Sure, I still go through hypnosis on a regular, although less intense, basis, but it beats the pain, recovery time and cost of surgery. I figured it out, and I save thousands staying out of the operating room!
All in all, the choice was a good one for me. I'd recommend it to anyone who is suffering from chronic pain and can't find relief. Hypnosis just may work for you.
Years down the road I found myself a patient repeatedly visiting doctors' offices for chronic back pain. I did not want to undergo surgery of any kind, but chronic pain management through medication was not working. At least, it was not working well enough. When one doctor suggested I try hypnosis to help ease my chronic pain, I was on board from the get go. I am sure, had I not had the positive past experience, I would have been more than hesitant to try it out.
I started hypnosis therapy for my chronic pain in June. By August I was feeling some relief from the chronic back pain. Through hypnosis therapy, I was able to learn to embrace the chronic pain and teach my body to accept it. I found that the more my body fought the pain, the more chronic back pain I felt. Through hypnosis I learned more relaxation techniques, not so different from the stress relievers I needed in my college days. I also learned to take care of my body in general better. All of this, combined with my medication, has helped manage my chronic pain. Through the use of hypnosis, I was able to stay out of the hospital, and I only go to the doctor's office for regular check-ups now, not for chronic pain complaints.
Granted, my story of beating chronic pain through hypnosis is one of success. Hypnosis does not work for everyone, especially anyone who is overtly skeptical of the practice. Non-believers, as I like to call them, are less receptive to the power of suggestion used during hypnosis. Again, no one suggests you cluck like a chicken, but the strategies of relaxation are channeled through suggestion. Similarly, individuals who are skeptical of hypnosis to cure their chronic pain tend to be tense during the hypnosis. Again, the hypnosis will not work. I have been told that with repeated sessions, some non-believers can even begin to feel relief as they begin to relax within the treatments.
All I know is I don't classify myself as a person with chronic backpains anymore. I don't limit myself or because of possible chronic pain or flare-ups. Sure, I still go through hypnosis on a regular, although less intense, basis, but it beats the pain, recovery time and cost of surgery. I figured it out, and I save thousands staying out of the operating room!
All in all, the choice was a good one for me. I'd recommend it to anyone who is suffering from chronic pain and can't find relief. Hypnosis just may work for you.
Tips for Reducing Low Back Pain
As a massage therapist and a mother of an infant, I do a lot of work
that can strain my back. I see many clients, as well, whose main
complaint is low back pain. This debilitating and common problem can be
prevented and relieved by following my easy suggestions.
This article is not intended as medical advice, but only a guide to help you address your low back pain. I offer you what has worked for me and for my clients, as well as my knowledge as a body worker. If these tips do not help, or if your low back pain is severe or debilitating, please see an osteopath, chiropractor, or medical doctor.
The first factor to look at in the instance of low back pain is posture and body alignment. Many people, especially women, arch our low backs by sticking out our butts. This overstretches the hamstrings, weakening them, and tightens the Quadratus Lumborum (QL) muscles, which sit between the rib cage and the pelvis. Hypertension or chronically tight QLs is a common cause of all sorts of low back and hip pain. Tight muscles can cause trigger points, which are spots that trigger pain in another area; for instance, a trigger point in the upper QL, just below the twelfth rib, can cause pain in the butt muscles and thighs. What is often mislabeled sciatica can actually be due to trigger points in the QL or a chronically tight piriformis muscle, which runs from the sacrum (the flat bone at the top of your butt) to the top of the leg bone. The piriformis can be tight from rotating the legs outward, or even from tight QLs that are tweaking the entire hip area.
To achieve proper alignment in the low back and pelvis, stand with your knees bent slightly and tilt your tailbone under, doing a hip thrust. Make sure your legs are about hip width apart, and your toes point straight forward. Now slowly straighten your knees, keeping your tailbone tucked. Keep it tucked as you relax your stomach muscles. Relax, but try to keep your tailbone tipped down a little. This may take some practice and repetition, but over time your muscles will learn how to stand with the pelvis appropriately aligned. Also notice while you walk if your toes point forward, or out to the sides like a duck. Try walking with your toes forward. Again, this will take time to learn if you have been walking with the leg bones turned out for years, but your hips will be grateful.
While going about your daily activities, notice the relationship of your low back to your legs and stomach. For instance, a common posture is to lean against the counter while washing dishes. This shortens both the hamstrings and the QLs, and strains the hip flexor muscles, the deep muscles that lift the legs as you walk or tilt the pelvis. If you carry a small child on your hip, you tilt the hip to one side. Much low back pain is cause by an imbalance in the muscles, especially while doing an activity like carrying a child. While washing dishes, change your posture to a more relaxed, aligned posture by bending the knees slightly and bending forward from the waist with a flat back instead of slumping into the counter. If you have a small child, get a sling or comfortable carrier like an Ergo to balance the weight. Wear your baby in different positions for both your and your baby's comfort. While wearing a child, be sure to squat to pick up things from the floor instead of bending over, which can strain the back.
If you sit a lot, which between the office and the car and the couch most people do, your back pain may be caused by strain on the back surface of the spinal muscles and discs, as well as from overstretched QLs. Standing up and stretching back gently as often as possible can help. Also include side stretches to relax the back muscles. Keep in mind that your body is three dimensional and integrated: your side and stomach muscles connect to and affect your back, as do the hip and leg muscles. Gently stretching and strengthening the entire body is key in any chronic body pain.
The best exercise I've found for low back pain is belly dancing. Yoga and weight lifting can help if the instructor knows of your low back problems and is careful to address them, but belly dancing, which is designed to protect the low back while strengthening the surrounding muscles, is truly the best exercise I've ever done for my back. Men would benefit, too, from learning a few moves just in the interest of protecting their backs. Insurance companies would do well to cover belly dancing classes, preventing costly back surgeries. (I'm not being facetious.)
Finally, a word about the psychological and emotional aspects of low back pain. The lumbar vertebrae are designed to support the organs, neck, and head. Chronic low back problems can, therefore, be about feeling unsupported. My own back pain is worse when I have too much to do, when I'm not making enough money, and when I have to care for my child alone. While the physical strain on my back during these times is clearly a factor, the emotional aspect plays a part as well. Getting the support you need, talking to a trusted friend or therapist about any feelings of fear or anger, and taking it easy as possible can also help your pain. Once several years ago, my back pain went away literally overnight after I got a much needed job.
Take care of your back by being aware of your posture and working to balance the muscles surrounding the low back and hips. Over time, your back pain will heal, and you will be able to move with the vigor and strength you were once used to.
This article is not intended as medical advice, but only a guide to help you address your low back pain. I offer you what has worked for me and for my clients, as well as my knowledge as a body worker. If these tips do not help, or if your low back pain is severe or debilitating, please see an osteopath, chiropractor, or medical doctor.
The first factor to look at in the instance of low back pain is posture and body alignment. Many people, especially women, arch our low backs by sticking out our butts. This overstretches the hamstrings, weakening them, and tightens the Quadratus Lumborum (QL) muscles, which sit between the rib cage and the pelvis. Hypertension or chronically tight QLs is a common cause of all sorts of low back and hip pain. Tight muscles can cause trigger points, which are spots that trigger pain in another area; for instance, a trigger point in the upper QL, just below the twelfth rib, can cause pain in the butt muscles and thighs. What is often mislabeled sciatica can actually be due to trigger points in the QL or a chronically tight piriformis muscle, which runs from the sacrum (the flat bone at the top of your butt) to the top of the leg bone. The piriformis can be tight from rotating the legs outward, or even from tight QLs that are tweaking the entire hip area.
To achieve proper alignment in the low back and pelvis, stand with your knees bent slightly and tilt your tailbone under, doing a hip thrust. Make sure your legs are about hip width apart, and your toes point straight forward. Now slowly straighten your knees, keeping your tailbone tucked. Keep it tucked as you relax your stomach muscles. Relax, but try to keep your tailbone tipped down a little. This may take some practice and repetition, but over time your muscles will learn how to stand with the pelvis appropriately aligned. Also notice while you walk if your toes point forward, or out to the sides like a duck. Try walking with your toes forward. Again, this will take time to learn if you have been walking with the leg bones turned out for years, but your hips will be grateful.
While going about your daily activities, notice the relationship of your low back to your legs and stomach. For instance, a common posture is to lean against the counter while washing dishes. This shortens both the hamstrings and the QLs, and strains the hip flexor muscles, the deep muscles that lift the legs as you walk or tilt the pelvis. If you carry a small child on your hip, you tilt the hip to one side. Much low back pain is cause by an imbalance in the muscles, especially while doing an activity like carrying a child. While washing dishes, change your posture to a more relaxed, aligned posture by bending the knees slightly and bending forward from the waist with a flat back instead of slumping into the counter. If you have a small child, get a sling or comfortable carrier like an Ergo to balance the weight. Wear your baby in different positions for both your and your baby's comfort. While wearing a child, be sure to squat to pick up things from the floor instead of bending over, which can strain the back.
If you sit a lot, which between the office and the car and the couch most people do, your back pain may be caused by strain on the back surface of the spinal muscles and discs, as well as from overstretched QLs. Standing up and stretching back gently as often as possible can help. Also include side stretches to relax the back muscles. Keep in mind that your body is three dimensional and integrated: your side and stomach muscles connect to and affect your back, as do the hip and leg muscles. Gently stretching and strengthening the entire body is key in any chronic body pain.
The best exercise I've found for low back pain is belly dancing. Yoga and weight lifting can help if the instructor knows of your low back problems and is careful to address them, but belly dancing, which is designed to protect the low back while strengthening the surrounding muscles, is truly the best exercise I've ever done for my back. Men would benefit, too, from learning a few moves just in the interest of protecting their backs. Insurance companies would do well to cover belly dancing classes, preventing costly back surgeries. (I'm not being facetious.)
Finally, a word about the psychological and emotional aspects of low back pain. The lumbar vertebrae are designed to support the organs, neck, and head. Chronic low back problems can, therefore, be about feeling unsupported. My own back pain is worse when I have too much to do, when I'm not making enough money, and when I have to care for my child alone. While the physical strain on my back during these times is clearly a factor, the emotional aspect plays a part as well. Getting the support you need, talking to a trusted friend or therapist about any feelings of fear or anger, and taking it easy as possible can also help your pain. Once several years ago, my back pain went away literally overnight after I got a much needed job.
Take care of your back by being aware of your posture and working to balance the muscles surrounding the low back and hips. Over time, your back pain will heal, and you will be able to move with the vigor and strength you were once used to.
What Exactly is Lumbago and How is it Treated?
Lumbago is a generalized term that is used to describe lower back pain.
Lumbago or lower back pain affects a large number of people and is
probably one of the main reasons people miss work and other activities
and events. While it is sometimes caused by a sports injury or other
movement, sometimes the cause is unknown. This article provides a
general overview of lumbago, as well as suggestions for treatment
options.
Lumbago is characterized by lower back pain that does not radiate from the legs. It may appear suddenly, or present as acute low back pain that gets progressively worse over a period of days. Often, there is a stiffness, especially in the morning, and the stiffness may progress to pain or lumbago over the course of hours or days. The back may also appear to be "crooked" - having an S-shape to the spine due to a muscle spasm that is likely causing the pain across the lower back.
The pain is actually caused by this muscle spasm, which is a symptom or secondary response to other conditions. Three may be a strain or sprain, a sports injury, a slipped disk, arthritis of the back, a kidney infection or a muscle bruise, among other causes. Sometimes, an affected person will remember a strain or injury, but other times, no cause can be recalled - there is just the lumbago or sore back as a result. Sometimes, the pain may be brought on by something as simple as a sudden harsh sneeze or bending down to pick up debris or tie a shoe. This condition can also be caused by scoliosis or other congenital abnormalities.
In the case of a minor injury or strain, treatment will normally involve bed rest and decreased activity and the use of anti-inflammatory drugs, pain relief and/or muscle relaxing medication. Warm compresses, or a hot bath or soak in a hot tub may also be recommended.
Some people seem to be more susceptible to lumbago than others and, in the case of reoccurring bouts with lower back pain, it may be necessary to see a doctor to determine the cause and participate in physical therapy or some other forms of treatment. A doctor will perform an ultrasound or X-ray to try to determine the exact cause of the reoccurring pain.
Some individuals find relief and treatment from Chiropractors or by seeing a massage therapist on a regular or specific basis. In the case that lumbago is chronic, ongoing treatment may be needed.
Lumbago is characterized by lower back pain that does not radiate from the legs. It may appear suddenly, or present as acute low back pain that gets progressively worse over a period of days. Often, there is a stiffness, especially in the morning, and the stiffness may progress to pain or lumbago over the course of hours or days. The back may also appear to be "crooked" - having an S-shape to the spine due to a muscle spasm that is likely causing the pain across the lower back.
The pain is actually caused by this muscle spasm, which is a symptom or secondary response to other conditions. Three may be a strain or sprain, a sports injury, a slipped disk, arthritis of the back, a kidney infection or a muscle bruise, among other causes. Sometimes, an affected person will remember a strain or injury, but other times, no cause can be recalled - there is just the lumbago or sore back as a result. Sometimes, the pain may be brought on by something as simple as a sudden harsh sneeze or bending down to pick up debris or tie a shoe. This condition can also be caused by scoliosis or other congenital abnormalities.
In the case of a minor injury or strain, treatment will normally involve bed rest and decreased activity and the use of anti-inflammatory drugs, pain relief and/or muscle relaxing medication. Warm compresses, or a hot bath or soak in a hot tub may also be recommended.
Some people seem to be more susceptible to lumbago than others and, in the case of reoccurring bouts with lower back pain, it may be necessary to see a doctor to determine the cause and participate in physical therapy or some other forms of treatment. A doctor will perform an ultrasound or X-ray to try to determine the exact cause of the reoccurring pain.
Some individuals find relief and treatment from Chiropractors or by seeing a massage therapist on a regular or specific basis. In the case that lumbago is chronic, ongoing treatment may be needed.
Preventing, Alleviating Pain Caused by High Heel Shoes
Backaches are a pretty common life occurrence. Things like sitting or
standing improperly or just over using the muscles can cause pain. Back
pain can also come from physical injury due to accident or simply
bending the wrong way. Some sources of pain are unavoidable while others
we bring upon ourselves. If you have a nagging back pain but you can't
figure out where it came from, you may want to consider your wardrobe.
Many women, myself included, love wearing high-heeled shoes. Not only are they stylish they can give you a bit of height and they help elongate the leg. Everywhere you look the 'sexy' woman is wearing heels. Victoria's Secret models and businesswomen alike are constantly photographed wearing heels. It's an image that has been burned into your mind since childhood. They can be sexy but they can also damage your back. Heels force your body weight to be thrown forward and the muscles in your back must work overtime to counteract this.
High heels have been around for almost as long as any other type of shoe. At one time heels were associated with being a person of privilege and wealth. In the 1930s the heel became associated with the fabulous starlet and the glamour that surrounded her. Playboy bunnies have been pictured with heels for decades cementing the 'sexy' image of the high-heeled shoe. What most women don't know is that there is a steep price to pay for everyday use of high heels and there is nothing sexy about the results.
The Damage
Women who wear heels on a daily basis can suffer from not only back pain but also bunions, misshapen muscles, curvature of the spine, painful knee and hip issues and osteoarthritis. That sounds sexy doesn't it? Let's not forget fallen arches and unsightly calluses.
When you wear heels most of your body weight is pushed down on your toes instead of the entire foot. Heels also make your legs, feet and hips work against the way they were designed to work. This adds stress to your bones, muscles and tendons. Add the average 10,000 steps a day to that and you might understand why your feet and back are hurting.
Help For Your Feet
Limit the time you wear your heels. If you feel you can't go to work without them there are things you can do to help your feet. Take a pair of slippers or flat shoes with you to work. When you are seated at your desk you can slip them off and put on the more comfortable shoes to give your feet a break. You can also wear sneakers too and from work and change into your heels when you arrive. If you are out on a date or with friends take the time to slip off your shoes once in a while and give your entire leg a good stretch.
Visit a chiropractor periodically to be sure your spine is not sustaining any damage from your choice of footwear. If your chiropractor suggests that you refrain from wearing heels take their advice.
Choose a lower and wider heel when shoe shopping. Though a wider heel won't help alleviate the effects of wearing heels they will give you a wider base support. This will help eliminate twisted ankles. A lower heel will put less stress on your entire body and can be just as sexy as the higher models.
Get the best fit possible by shopping for shoes late afternoon or evening. Your feet expand during the day. If you buy your shoes when your feet are at their largest size you will ensure a better fitting shoe. You should never wear a tight shoe because it adds even more stress to your muscles and bones. Avoid shoes that come to a point at the toe. When you wear these shoes your toes are squashed into an unnatural position that can damage and deform your toes over time.
Look for shoes that have grips and good cushioning inside. This will help your foot from slipping and sliding around inside your shoe, which may add extra stress to your already aching feet. If you love a pair of shoes but there is not padding you would be wise to buy inserts.
Baby your feet. After a long day in heels you should soak your feet in warm water. Not only is this good for your feet it will leave you feeling more relaxed all over. Constant heel wearing can cause your calf muscles to shorten. Take some time out of your busy day to stretch your leg, feet and back muscles.
Many women, myself included, love wearing high-heeled shoes. Not only are they stylish they can give you a bit of height and they help elongate the leg. Everywhere you look the 'sexy' woman is wearing heels. Victoria's Secret models and businesswomen alike are constantly photographed wearing heels. It's an image that has been burned into your mind since childhood. They can be sexy but they can also damage your back. Heels force your body weight to be thrown forward and the muscles in your back must work overtime to counteract this.
High heels have been around for almost as long as any other type of shoe. At one time heels were associated with being a person of privilege and wealth. In the 1930s the heel became associated with the fabulous starlet and the glamour that surrounded her. Playboy bunnies have been pictured with heels for decades cementing the 'sexy' image of the high-heeled shoe. What most women don't know is that there is a steep price to pay for everyday use of high heels and there is nothing sexy about the results.
The Damage
Women who wear heels on a daily basis can suffer from not only back pain but also bunions, misshapen muscles, curvature of the spine, painful knee and hip issues and osteoarthritis. That sounds sexy doesn't it? Let's not forget fallen arches and unsightly calluses.
When you wear heels most of your body weight is pushed down on your toes instead of the entire foot. Heels also make your legs, feet and hips work against the way they were designed to work. This adds stress to your bones, muscles and tendons. Add the average 10,000 steps a day to that and you might understand why your feet and back are hurting.
Help For Your Feet
Limit the time you wear your heels. If you feel you can't go to work without them there are things you can do to help your feet. Take a pair of slippers or flat shoes with you to work. When you are seated at your desk you can slip them off and put on the more comfortable shoes to give your feet a break. You can also wear sneakers too and from work and change into your heels when you arrive. If you are out on a date or with friends take the time to slip off your shoes once in a while and give your entire leg a good stretch.
Visit a chiropractor periodically to be sure your spine is not sustaining any damage from your choice of footwear. If your chiropractor suggests that you refrain from wearing heels take their advice.
Choose a lower and wider heel when shoe shopping. Though a wider heel won't help alleviate the effects of wearing heels they will give you a wider base support. This will help eliminate twisted ankles. A lower heel will put less stress on your entire body and can be just as sexy as the higher models.
Get the best fit possible by shopping for shoes late afternoon or evening. Your feet expand during the day. If you buy your shoes when your feet are at their largest size you will ensure a better fitting shoe. You should never wear a tight shoe because it adds even more stress to your muscles and bones. Avoid shoes that come to a point at the toe. When you wear these shoes your toes are squashed into an unnatural position that can damage and deform your toes over time.
Look for shoes that have grips and good cushioning inside. This will help your foot from slipping and sliding around inside your shoe, which may add extra stress to your already aching feet. If you love a pair of shoes but there is not padding you would be wise to buy inserts.
Baby your feet. After a long day in heels you should soak your feet in warm water. Not only is this good for your feet it will leave you feeling more relaxed all over. Constant heel wearing can cause your calf muscles to shorten. Take some time out of your busy day to stretch your leg, feet and back muscles.
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