Fast Fitness - Exercise Involvement In World Health
Friday, October 30, 2009
Jolie Bookspan, M.Ed, PhD, FAWM
Here is Friday Fast Fitness - shed unhealthy petty feelings of maltreatment because you had to wait in line for your luxury items, or didn't get them in your color.
We have things to be extremely grateful for.
More of the time, it is not necessary to gain them through harming others or the Earth.
Lead by example. Teach children and others not to litter, pollute, harm others, do harm for money, do harm for power, harm themselves.
Check Simple Ways to Get Started:
My Academy- the Academy of Functional Exercise Medicine (AFEM) teaches people and communities how to be healthy in body and actions. Readers who use my work have been teaching their groups simple healthy bending and movement for daily life instead of injury producing habits, good food instead of disease causing food, healthy training for high level athletics and military, healthier medical practices for sick, injured, preventive medicine, "green" fitness, and healthier mindset. Come join us by doing simple things in your home and community - click AFEM.
Read success stories of these methods and send your own. Before asking questions, see if your answers are already here by clicking labels under posts, links in posts, archives at right, and The Fitness Fixer Index. Subscribe to The Fitness Fixer, free. Click "updates via e-mail"(under trumpet) upper right. For personal medical questions - Replies to Medical Questions. Limited Class spaces for personal feedback. Top students may apply for certification throughDrBookspan.com/Academy. Learn more in Dr. Bookspan's Books.
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Images sent to me by Dear Colleague Dr. Ern Campbell - ScubaDoc
Halloween - the time when I take off my lab coat for work, and others put them on for costumes. A time when we dress as groups who pledge: "An it harm none, do what ye will" also stated as, "First, do no harm." Who are these groups? Read on.
The Wilderness Medical meeting where I have been teaching certification courses held a costume banquet last year. Medical professionals and students dressed in costumes depicting wilderness medicine. One couple was wearing outdoor clothing. I looked again and their faces were covered in red face paint. Except around their eyes, strangely pale. Also long thin white strips from eyes to ears. Sunglasses were propped on top of their head. They were sunburn. (White areas were those unburned, shielded by the glasses.) Another student was wearing regular clothing, except there was a large bat attached to his chest. Look closer. His face had strange white around the mouth. Rabies! Professors of envenomations wearing suit jackets covered with plastic bugs and snakes. Another wearing a giant falciparum, a protozoan parasite that causes malaria. Many others, simple, intelligent, and fun. When a solution in medicine is brilliant and simple at the same time, it is called "elegant."
For other events, one year I wore black jeans and sweater, and held up a black card with a white circle enclosing a black 8. People shrugged, "Oh, an 8-Ball."
I flipped the card. It was a black card with a blue triangle that read "I am The Magic 8 Ball" which got some laughs. Flipping over the cards got them another blue triangle that read, "You May Ask Your Question Now" I came ready with cards and never had to say a word. They flocked over. Lots of questions. Funny how they can all be answered by the Magic 8 Ball. A couple walk over together: 8 Ball: "I am The Magic 8 Ball." He: "Will I get lucky tonight?" 8 Ball: "Doubtful" She: "Will *I* get lucky tonight?" 8 Ball: "Outlook Good" He: "Hey!! Not fair, how do you know that?" 8 Ball: "I am The Magic 8 Ball" She: "Hey, you thought of a good costume" 8 Ball: "My Sources Point To Yes."
Read success stories of these methods and send your own. Before asking questions, see if your answers are already here by clicking labels under posts, links in posts, archives at right, and The Fitness Fixer Index. Subscribe to The Fitness Fixer, free. Click "updates via e-mail"(under trumpet) upper right. For personal medical questions - Replies to Medical Questions. Limited Class spaces for personal feedback. Top students may apply for certification throughDrBookspan.com/Academy. Learn more in Dr. Bookspan's Books.
Thank You Code Blog for collecting the best medical articles of the week for the Halloween Edition, and including my Kneecap Tracking article among the scary entries. A reader's doctor says the fix for tight knee muscles is to cut the muscles. That is scary when pain can be stopped by stretching them instead.
On the web, Grand Rounds is a collection of the best on-line medical articles from the past week. A different host works hard each week to find and list the articles. This is different from the Grand Rounds in a hospital, which is a lecture for doctors about a patient or topic.
Thank you to this week's host, Code Blog Tales of a Nurse, for the hard work of collecting and featuring our posts for Grand Rounds Volume 6, Number 6.
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Subscribe to The Fitness Fixer, free. Click "updates via e-mail"(under trumpet) upper right.See more in the archives at right and The Fitness Fixer Index. Read success stories of Fitness Fixer methods and send your own. For personal medical questions - Replies to Medical Questions. Limited Class spaces for personal feedback. Top students may apply for certification throughDrBookspan.com/Academy. Learn more in Dr. Bookspan's Books.
A number of conventional standardized fitness tests, surprisingly, are not accurate. They do not test what they claim to test. To get real answers that you can use, it is important to know if you are doing what you think you are doing.
An example of a test that does not test what it claims is the "Sit and Reach" test. Sit and Reach is assumed to test hamstring flexibility, but is more a measure of how much you can round your spine. Many people can pass the Sit and Reach with little hamstring flexibility and an unhealthful angle at the hip - tilted back (shown by shorts side seam) rather than vertical. The Sit and Reach is required testing for numerous military, corporate, and school fitness programs
Another standard fitness assessment uses crunches or sit ups, supposedly to test abdominal muscle function. Bending or curling forward does not give a predictive measure of how well you can use your abdominal muscles to adjust your spine position for spine health, for sports ability, to prevent back pain, in short, to move in healthy ways in real daily life and work where you need it most.
A test may be reliable, which means it gives the same answer each time you test the same thing. For example, a scale should measure the same item at the same weight each time. A reliable scale may not be accurate. That means, it may be wrong by the same amount each time. But it does give the same answer reliably. Having a reliable test does not mean it will be accurate. Accuracy and reliability are both necessary components of devising tests that are actually helpful.
I worked years researching more prognostic and beneficial tests for several common fitness measures. If your military or police division, school, or industry wants to hire me to train you in simple new reliable and accurate tests, let me know.
Subscribe to The Fitness Fixer, free. Click "updates via e-mail"(under trumpet) upper right.Before asking questions, see if your answers are already here by clicking labels under posts, links in posts, archives at right, and The Fitness Fixer Index. Read success stories of Fitness Fixer methods and send your own. For personal medical questions - Replies to Medical Questions. Limited Class spaces for personal feedback. Top students may apply for certification throughDrBookspan.com/Academy. Learn more in Dr. Bookspan's Books.
Here is Friday Fast Fitness - another contest! Do you know what constitutes ability in balance as a lifestyle? Tell us!
On the urging of reader Mr. Georges Nakhlé, I started the Academy of Functional Exercise Medicine (AFEM) to train people in healthier, functional, more common-sense exercise and lifestyle. We teach classes, certify top students, and are creating better methods of instruction.
One of our courses is Balance. Mr. Nakhlé, who runs the AFEM office in Lebanon asked me, "Which test tells whether a person has good balance or not?"
Readers - Your Challenge:
Write your ideas for different needed levels of balance
Write specific balance skills or training drills
Give examples that are needed for real daily life - functional balance testing, rather than isolated clinical measures.
Here Is What To Know:
Standardized tests exist, but don't predict how someone can function (move doing real things) in real life without falls, sprains, and other injuries of poor balance. A single test, such as the standard, "Can you stand on one foot for 5 seconds" may give a low basic measure, but a single test doesn't cover range needed throughout real life. That means we need several simple tests to rank ability.
Examples:
Basic low level balance needed for safe healthy life:
"Can you step over a pile of clothes and toys on the floor, without spilling a cup of water"
"Can you descend narrow basement stairs holding a laundry basket in both hands without holding the railing?"
"Can you put on hosiery and shoes standing up?"
"Can you rise from your chair and the floor without using your hands?"
Average:
"Can you leap over a puddle or hole in the street and land lightly on the other foot?"
"Can you safely climb a stepladder without hands and change an overhead light bulb without holding on?"
High:
"Can you walk though a rushing rocky stream and rescue a child on a rock?"
Your ideas here…
Last contest time running out - How well do you know human movement?
Subscribe to The Fitness Fixer, free. Click "updates via e-mail"(under trumpet) upper right. Before asking questions, see if your answers are already here by clicking labels under posts, links in posts, archives at right, and The Fitness Fixer Index. Read success stories of these methods and send your own. For personal medical questions - Replies to Medical Questions. Limited Class spaces for personal feedback. Top students may apply for certification throughDrBookspan.com/Academy. Learn more in Dr. Bookspan's Books.
Forward Air Head Syndrome - Doing Sets and Reps and Missing The Point of the Exercise
Thursday, October 22, 2009
Jolie Bookspan, M.Ed, PhD, FAWM
After the article Help Yourself last Monday, I received many notes from readers. Almost a dozen the first few hours. Notes saying that that once they understood how my method changes "doing" exercises into stopping causes of injury, they tried to help their friends who had pain. The friends turned their generous help back into the party line of doing sets and reps of stretches and exercises, then returned to habits that recaused their injury. They missed the greater point of using the retraining after the reps stop - during actual real life.
One reader wrote how he explained to his friend about the cause of degenerating discs and vertebrae of the neck. His friend was constantly jutting the neck forward - a painful posture called a "forward head." The friend protested that he had a disease of the facets, the joints of the vertebrae. The reader explained that damage to the facets was caused by the bad posture called a forward head. The friend insisted he had disc deterioration and bulging. The reader explained the cause was simple bad posture called a forward head. The friend agreed to try my method, did a few stretches mentioned in part of one of my articles, then went back to their forward head posture, and complained that the method didn't work because pain returned. He wanted to know exactly how many and which other exercises to do and how long it would take for the exercises to work.
Check some of the comments to certain Fitness Fixer articles. Some commenters miss the point that the stretches or exercises may help you feel better for the moment (and if they don't then you are doing them wrong) but you must change injurious movement habits. Prevent tilting your hip and use neutral spine instead when you stand and walk, to prevent lower back and SI pain. Stop craning your neck. These are voluntary actions that need your brain to work.
Reader Paul J wrote this accurate assessment:
"The Department for Silly Syndromes has determined that Forward Air Head Syndrome is closely related to Cerebral Detachment Syndrome that occurs in patients that read the writings of Dr. Bookspan.
"The patient knows how to read and understands words; however after reading Dr. Bookspan’s writings, a detachment in the cerebral cortex seems to occur often affecting the patient’s ability to think and type. The patient exhibits some of the following symptoms:
Writing questions to answers already given in the original text,
Writing questions to answers already given in previous articles
Writing questions that are not congruent.
In mild forms, the patient will read some of the information, do some stretches, and expect complete results.
"The recommended treatment for those suffering from CDS is to watch the movie* ‘What About Bob?’ This may not cure CDS however it should temporally delay the effects of CDS."
(*In the movie, a psychiatrist gives his nice but overanxious patient a book, to understand and solve his own problems. Instead, the patient drives the psychiatrist insane with repeated unneeded questions (and did his previous doc in with the same).
Read success stories of these methods and send your own. Before asking questions, see if your answers are already here by clicking labels under posts, links in posts, archives at right, and The Fitness Fixer Index. Subscribe to The Fitness Fixer, free. Click "updates via e-mail"(under trumpet) upper right. For personal medical questions - Replies to Medical Questions. Limited Class spaces for personal feedback. Top students may apply for certification throughDrBookspan.com/Academy. Learn more in Dr. Bookspan's Books.
This week's Grand Rounds combined the usual Grand Rounds (health & medicine "best of" list) with Encephalon (brain & mind edition). To use BIPOD, you need to use your brains.
In a hospital, Grand Rounds is a lecture for doctors about a patient or topic. On the web, Grand Rounds is a collection of the best on-line medical posts from the past week. A different host works hard each week to find and list the articles.
Reps of Exercises Don't Fix Pain; Fixing Causes Does
Monday, October 19, 2009
Jolie Bookspan, M.Ed, PhD, FAWM
Monica from Montana bent over dogs daily in her dog boarding kennel. She spent the summer doing stretches, exercises and going to chiropractors for severe back pain. She did all her "sets and reps" (repetitions) of the exercises her various practitioners gave her. The pain kept coming back. What did she do differently that stopped this cycle?
I first heard from Monica through her short happy note:
"Thank You!! So much. I've had quite the drain of lower back pain the whole summer. Finally I got online and read your article and have now begun the fast road to recovery. The first day I did have relief. Now it's been three days and I can't stop talking about how good I feel. Today I drove six hours and was still comfortable! "Thank you again, "Monica "Montana"
I wrote to thank her for using my work as intended and taking time to tell me. She replied:
"Hi Dr. Bookspan, "The whole summer of 2009 was plagued with lower back pain, I thought due to raking pine cones. I did my usual routine. Going to the chiropractor. Doing stretches (the wrong stretches) all day long thinking they were giving me relief and come to find out by reading your website I was re-injuring my back over and over by doing these improper stretches of bending forward. When I found your website it all made sense so I immediately implemented your instruction and what do you know I immediately started feeling better.
"The pain did not all go away over night, it has taken time to heal, tolerable time thank you. At the end of August I wrote to you saying thank you. It is now the first part of October and the lower back pain is pretty much gone.
"When the pain makes an appearance I immediately pay attention to body position and it (the pain) goes away. I also suspect the chairs I use at work were a part of setting me up for this injury. The chairs are like saddles to "help with upright posture." The molded hard part of the back of the chair is protruding to where it was subtly pushing on my tail bone I've now realized. I think that's a part in why the injury was so low in my back. Plus I think the saddle part of the chair had been affecting my hips. This has taken some time to realize I was so used to these chairs. This whole combination has caused quite a bit of pain and discomfort but due to your website I started looking at all of these things and am reaping the benefits.
"Thank You Dr. Bookspan! You are a bright expression of this essence we all are. The essence of compassion, clarity and skillful means. "Much Love, "Monica
Thank you Monica, for lovely writing.
I wrote back to Monica to see what, specifically, she found helpful, and make sure that after time, she remained pain free, had her life back, and could do more than before she started using my work. To help readers, I make sure these reader inspiring stories are tutorials, not just testimonials. For new readers who have not previously heard of fixing causes rather than doing a few sets and reps of exercise and stretches, I ask success story writers to include specifics.
Monica continues with two commonly prescribed forward bending stretches that add to a common source of pain, rather than fix any problem:
"The main (wrong) exercise I kept repeating over and over was to sit in a chair, bend forward with arms between my legs to stretch as much as I could. This would make my spine move as if straightening - I thought. I also found that bending forward over the front knee created a stretch that would make my spine move. I realize now this was not a good thing."
She also described habitual body positioning that are classic contributors to pain. Even if you do all your sets and reps of exercise and stretches, if you don't prevent these causes of pain, you won't stop the resulting pain:
"My habits have been to let the bottom of my pelvis bend back at while sitting or standing. You know the "butt out" posture. While walking, my feet tend to face outward too. I've now been more conscious to keep my feet square and tilting the bottom of my pelvis forward to give my spine more support. Works like a charm.
"For real life bending... The first thing I do in the morning is go feed dogs in my dog boarding kennel, so in order to pick up bowls and put them back down I now bend my legs instead of bending over using my back. I try to keep my heels to the ground and come up easy while I'm still gaining strength to take care of my knees. My legs have adapted quickly. I bend using my legs all day long and really try to take care of my knees and back.
"I hope this helps someone. "Warm Regards, "Monica"
If You Have Questions How To Do This For Yourself:
Read success stories of these methods and send your own. Before asking questions, see if your answers are already here by clicking labels under posts, links in posts, archives at right, and The Fitness Fixer Index. Subscribe to The Fitness Fixer, free. Click "updates via e-mail"(under trumpet) upper right. For personal medical questions - Replies to Medical Questions. Limited Class spaces for personal feedback. Top students may apply for certification throughDrBookspan.com/Academy. Learn more in Dr. Bookspan's Books.
Fast Fitness - Contest: What Does It Take To Sit Upright?
Friday, October 16, 2009
Jolie Bookspan, M.Ed, PhD, FAWM
Here is Fast Friday Fitness - a Contest!
Conventional beliefs about posture include that you must do certain exercises or stretches or strengthening to change your posture. Is that true?
Look at photo 1 and 2 and answer the simple question below:
Photo 1
photo 2
Submit Your Answer:
What muscle strengthening or stretch is required to change from first (unhealthy rounded) to second (upright) sitting?
Name the muscle(s) and action needed - don't just name a muscle, say which way it needs to pull.
Explain why the same people (with the same tightness or weakness) who sit with the lower spine rounded forward (flexion) often stand with the lower back overly curved inward (hyperlordosis) - just the opposite.
Disregard the leg position in the two photos - the question is not how to move the leg, those were just the two photos I could find. Focus on describing how to change yourself to upright sitting without moving the leg (why? if you need to move the leg, then you are too tight for basic health. This question is how to restore that basic).
Use your brain. Partial credit applies. I will post answers, explanations, and winners.
Hint for success:
Sit and try it yourself, don't go only to anatomy books.
Read inspiring success stories of these methods and send your own. See if your answers are already here by clicking post labels, links, archives at right, and Index. For answers to personal medical questions - Replies to Medical Questions. Subscribe free, "updates via e-mail" upper right. Limited Class space for personal feedback. Top students may earn certification,DrBookspan.com/Academy. Learn more (answer to this quiz too) in Dr. Bookspan's Books.
Exercise and Weight Loss Reduces Kidney Disease and Death
Wednesday, October 14, 2009
Jolie Bookspan, M.Ed, PhD, FAWM
We recently found a cure for "irony deficiency disease." My near-7 foot tall husband and I were walking to a Vidocq forensic society meeting. A bake sale was set up in the building lobby - junk food, refined junk pastries, pies with artificial colorings. The sign stated "Bake Sale for Kidney Disease." I asked which items caused the most kidney disease. I was sure it was a staged joke for a commercial on nutrition awareness. The sellers were disappointed with me. Apparently, it was a real bake sale. "Bake Sale for Kidney Disease" is true, both for them and their kidneys.
Research reported in the Clinical Journal of the American Society Nephrology of pooled data from 13 studies showed found, in obese adults with kidney disease, losing weight through diet and exercise prevented additional decline in kidney function and reduced proteinuria, which is excess excretion of protein in the urine, a major characteristic of kidney damage.
Regular exercise of the recommended amount cuts risk of death in patients with chronic kidney disease by 56%, according to an analysis of National Health and Nutrition Examination Survey (NHANES) data. People who exercised, but less than recommended levels were still 42% less likely to die during follow-up than sedentary people.
1. Weight Loss Interventions in Chronic Kidney Disease: A Systematic Review and Meta-analysis. Sankar D et al. Clin. J. Am. Soc. Nephrol., September 17, 2009 as doi: 2. Physical Activity and Mortality in Chronic Kidney Disease (NHANES III). Beddhu S, et al. Clin J Am Soc Nephrol 2009; DOI: 10.2215/CJN.01970309. doi:10.2215/CJN.02250409.
Obesity is a major factor in kidney disease. A large percentage of the United States adults and children are overweight or obese, increasing their risk of kidney ailments, plus diabetes and high blood pressure, which in turn affect kidney function. More than 20 million Americans already have chronic kidney disease, with the number and severity growing.
Researchers of the Systematic Review and Meta-analysis stated,
"The health care costs that are associated with this increase are staggering. In obese adults, weight loss may offer real benefits in terms of the kidneys, in addition to the heart-related benefits of shedding excess pounds."
--- Read and contribute your own success stories of these methods. Before asking questions, see if your answers are already here - click labels under posts, links in posts, archives at right, and the Fitness Fixer Index. For answers to personal medical questions - Replies to Medical Questions. Subscribe to The Fitness Fixer, free. Click "updates via e-mail"(under trumpet) upper right. See Dr. Bookspan's Books, take a Class, get certifiedDrBookspan.com/Academy.
"It reminded me of a conversation I had yesterday with one of my neighbours. She is 71, very much overweight and is in a lot of pain. She has been receiving physical therapy for the last year. Not having much success she asked her doctor to refer her to a specialist. The results of her x-ray show that she has 2 herniated discs. She also has arthritis plus her lower spine has a curve.
"I mentioned your name and said that herniated disks can heal. I showed her how to stand with a neutral spine. She did not want to know. You have probably come across people like this time and time again. The way she spoke, she wants to have surgery. I was horrified.
"What could I do???? Sadly, I walked away.
"Over the years, she has complained about her weight. I have tried to help in a nice way. How can one help a lady who sits all day long watching TV, eating. So sad. One has to help oneself."
Mindset alone can't fix pain. You can want something until you are blue in the face, but that will not change what happens. You need to do the steps needed. It's also sometimes hard or impossible to do the steps on your own, and a little help is needed. A flame can't ignite on its own.
--- Read and contribute your own success stories of these methods. Before asking questions, see if your answers are already here - click labels under posts, links in posts, archives at right, and the Fitness Fixer Index. For answers to personal medical questions - Replies to Medical Questions. Subscribe to The Fitness Fixer, free. Click "updates via e-mail"(under trumpet) upper right. See Dr. Bookspan's Books, take a Class, get certifiedDrBookspan.com/Academy.
Fast Fitness - BIPOD Reader Prescription for Healthier Feet
Friday, October 09, 2009
Jolie Bookspan, M.Ed, PhD, FAWM
Here is Friday Fast Fitness - BIPOD is a way to happier feet that you can do yourself at home. Reader Paul J sent in this gem in July. Other great work from him and other readers are still in the piles of mail.
For background: A shoe insert is any pad of any size, shape or quality that you put in your shoe for various reasons. Hard shoes are a common course of joint pain. Many shoes benefit from better cushioning and even a cheap soft insert for cushioning purpose can help that. Orthotics are different. Orthotics are hard shapes, specially fitted by a trained orthotist or sometimes a physical therapist with orthotic training. Orthotics usually cost a few hundreds of dollars. Orthotics are rigid forms to hold your feet in a specific position. There are also hard inserts with molded arch or other area advertised to change your foot posture. Sometimes orthotics and hard inserts make more pain or don't change the source of the problem. Most of the time, for non-paralyzed people, if the orthotic can make your foot change to a healthy position, you can do the same using your own muscles and sense of positioning. Using your own feet and ankle muscles is often healthier, more comfortable, and more likely to yield long term results.
Now Paul J's intelligent prescription:
"Bookspan Invisible Pain-free Orthotic Drops - BIPOD. Now you can walk, run, or stand without the pain of traditional hard orthotic inserts. BIPOD will revolutionize the way you stand. Read and follow product instructions, failure to do so will render this product ineffective. Attempts to walk, run, or stand without BIPOD is not recommended by our accountants.
"In order to reduce the burden on landfills, please follow the directions below to make BIPOD at home. You must use your brain and following all directions in order to get DHMO and CS (see above).
Ingredients: one tablespoon of cold tap water one tablespoon of tap water from hot tap, before it gets hot.
Mix for 4 seconds in a container that can hold 2 _ tablespoons of liquid.
"The left over mixture maybe placed in the refrigerator for later use or discarded in most plants."
Remember - get the point of healthy practices. Don't get bogged down on purchasing exercise machines and expensive devices that reduce your own body's involvement in your life, or trivial details of exercise "form." Get the big picture of easy healthier ways and enjoy improving your life.
Many readers' great stories are in the piles. Remember to read the instructions and concepts in articles on fixing pain first before asking what to do. Gain the benefits and better health and send in that story. Then we can all enjoy more instead of taking time plodding through and answering reader comments of, "I read your work on how to fix neck pain, will your stretches work?" and similar instances of missing the point. Would anyone help Hannah (or Cheryl?). She left the 36th comment asking if the stretches work on Fixing Upper Back and Neck Pain, which had already explained, along with the 35 questions and replies already there. Thanks!
--- Read and contribute your own success stories of these methods. Before asking questions, see if your answers are already here - click labels under posts, links in posts, archives at right, and the Fitness Fixer Index. For answers to personal medical questions - Replies to Medical Questions. Subscribe to The Fitness Fixer, free. Click "updates via e-mail"(under trumpet) upper right. See Dr. Bookspan's Books, take a Class, get certifiedDrBookspan.com/Academy.
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Image of helping feet with brains by "lapolab" via Flickr
Thank you Pallimed for not including me in your votes of the best in palliative medicine for Grand Rounds Vol 6, No 3 this week. Palliative medicine, by definition, means to alleviate pain and symptoms without eliminating the causes. Palliative comes from the Latin palliare, meaning "to cloak." My life's work is not to cloak problems but stop causes.
Palliative care is sometimes all that is considered possible in situations of end of life or hospice, and those are difficult situations needing some cloaking and definite soothing of symptoms. There are also times where addressing causes can be included, with good results to stop the entire problem.
Pallimed did include one of my articles Fixing Discs by Fixing Causes, by shunting it to their comments section. In Fixing Discs by Fixing Causes, Fitness Fixer reader Laraine P had previously tried palliative measures for the pain of her herniated discs, then changed movement practices to healthy ones so that the discs themselves could heal and the pain stop.
On the web, Grand Rounds is a collection of the best on-line medical posts from the past week. A different host works hard each week to find and list the articles. This is different from the Grand Rounds in a hospital, which is a lecture for doctors about a patient or topic. Thank you Pallimed for all your work.
--- Read and contribute your own success stories of these methods. Before asking questions, see if your answers are already here - click labels under posts, links in posts, archives at right, and the Fitness Fixer Index. For answers to personal medical questions - Replies to Medical Questions. Subscribe to The Fitness Fixer, free. Click "updates via e-mail"(under trumpet) upper right. See Dr. Bookspan's Books, take a Class, get certifiedDrBookspan.com/Academy.
Poor tracking is not a disease or a syndrome, or that you are doomed to arthritis. Usually it is a simple injury process that can be stopped. Tracking problems are often given several names: Lateral Facet Syndrome, Chondromalacia, Anterior Patello-Femoral Pain Syndrome, Lateral Pressure Syndrome, Malalignment Syndrome, Maltracking Syndrome, Patello-femoral Degenerative Arthritis, and other scary names. Not all of these are due to poor tracking. Calling something tracking when it is not, often leads to much time trying tracking "cures" when you need other things.
Instead of surgery, you can stretch the tight side areas and retrain the weak ones, so the kneecap slides normally instead of grinding sideways in its channel. Stopping causes stops need for surgery, or even bracing and pain pills. The knees heal and you go back to all you want to do, using the new healthy mechanics.
What can you do when pain continues after physical retraining? Captain Scott wrote that he had been to physical therapy for his knees "for a few months without much success." He had previously endured ongoing treatments for back pain, then discovered Fitness Fixer methods and resolved the pain. He came back to see if he could do the same for his knees.
Kneecap tracking should begin normalizing within days of stopping causes - far sooner than "a few months." If not, one obvious thing to check is if you have the right re-tracking stretches, exercises, and functional retraining. After that, here are four common reasons when PT does not "work."
Tracking Exercises That Don't Fix Tracking. A common PT scenario is doing 10 (or however many) repetitions of straightening the knee against resistance of a stretchy band, called "terminal extensions," "setting" exercises such as squeezing things between the knees, stretching the lateral (side structures), and small leg lifts with ankle weights to strengthen inner thigh muscles (VMO)s. Without retraining gait and knee use during real life movement, the person often gets up from the PT session and walks away and goes back to their activities with the same poor tracking. PT needs to look at and fix specific use during real life activity - do you turn your knee inward or your feet outward, do you let your foot flatten, do you let your upper leg bone rotate, do you walk with your feet turned outward (duckfooted) or inward (pigeon toe). Weight or resistance used is often far less than what the knee encounters when the person stands up and uses their knees to walk away from their exercise session. Tracking angles should monitored during rehab. Not just during standing or during leg lifts, but during the patient's customary activities. If they are not changing, and they are the confirmed cause, then you may not be changing tracking.
Are You Sure It's a Tracking Problem. Knees can hurt for other reasons. Not all patello-femoral pain is from tracking. You can go for the best re-tracking programs, but if your knee does not have an actual tracking problem, it is no mystery when tracking exercises do not help. You have not spent time fixing the cause. Make sure that tracking is the reason before treating for tracking. Tracking can be identified with specific patellar x-rays or other scans that can clearly include position during several points of motion. Tracking also can be visualized - look at kneecap path during quadriceps use during several kinds of movement. The kneecap slides up and down obviously under the skin at the knee during use. There is a variable degree of normal angle at the knee. Human legs are not straight from upper to lower leg. That angle at the knee allows us to walk upright on two legs in a smooth gait. The angled knee is one of many markers that tell forensic scientists and anatomists if the leg bones they are looking at are human. Sometimes a normally tilted kneecap slide is misidentified as a tracking problem when it is a normal angle in line with the joint.
Multiple Causes. Sometimes tracking mal-alignment is confirmed and rehab done. The patella tracks normally and stops wearing the area, but pain continues from other causes. No mystery. Check for other poor knee mechanics that cause injury. Check if your shoes are too hard. Many people paying for "good supportive shoes" get knee pain from the hard shoe. Often the pain from bad shoes is sharply outlined around the kneecap with deeper aching. Check your bending. If you have pain with knee bending (squatting), fix that. Check your stretches. Some twist the knee joint, such as lotus and hero poses in yoga, hurdler's stretch and others. Stretches should stretch muscles, not cartilage in joints. Fitness Fixer articles summarize and my books detail more.
Medicines that Cause Pain. Whether you have tracking problems or not, common prescription medicines cause pain that does not respond to PT. Look into stopping reasons you need the medicines in the first place, and save yourself time, money and pain.
My idea of health care is a quick, straightforward assessment of causes and intelligently addressing them. That beats having someone stick a knife in your knee and charging you for it.
Health&Fitness in Plain English THIRD edition - How to Be Healthy, Happy, and Fit for the Rest of Your Life. Both available from www.DrBookspan.com/books.
The British Journal of Cancer published a study finding that, "Exercise, including manual labor, cuts colon cancer (the most common kind of bowel cancer) by a quarter."(1)
Another study by the Division of Population Science at the Fox Chase Cancer Center found that, "People who get lots of exercise have a 30 percent to 40 percent lower risk of developing colon cancer" and that "A sedentary lifestyle accounts for as many as 14 percent of all colon cancer cases in the United States." (2)
They stressed in their findings that of 1,932 adults who answered questions about colon cancer risk, 85% did not list physical activity as a method of reducing their risk of colon cancer, and that "not all doctors are informing patients of this simple preventive approach."
According to Dr. Edward Giovannucci, professor at the Harvard School of Public Health, "Sedentary people can greatly benefit from starting a modest exercise program, such as gardening or walking two to three hours a week. Sedentary people should first set such moderate, achievable goals. More benefits could accrue from higher levels and more intense exercise, such as jogging, running or tennis. To some extent, more may be better, but it is important to note that a little is much better than nothing."
1 KY Wolin et al. Physical activity and colon cancer prevention: a meta-analysis. British Journal of Cancer. Volume 100 Issue 4, 2009. 2 Coups EJ, Hay J, Ford JS. Awareness of the role of physical activity in colon cancer prevention. Patient Educ Couns 71(2), 2008.
Key Encouraging Points:
Exercise has definite, positive effect to reduce colon cancer risk
Exercise reduces risk, even if you have a family history, or risk factors for the disease.
Colon cancer is considered a largely preventable disease.
--- Before asking questions, see if your answers are already here - click labels under posts, links in posts, archives at right, and the Fitness Fixer Index. For answers to personal medical questions - Replies to Medical Questions. Read and contribute your own success stories of Fitness Fixer methods. Subscribe to The Fitness Fixer, free. Click "updates via e-mail"(under trumpet) upper right. See Dr. Bookspan's Books, take a Class, get certifiedDrBookspan.com/Academy.
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Image by lantzilla via Flickr, no derivitave works
Fast Fitness - Third Group Functional Training Exercise: Ankles and Knees in Jumps and Landings
Friday, October 02, 2009
Jolie Bookspan, M.Ed, PhD, FAWM
Here is Fast Friday Fitness - third in the series of Functional Fitness Training (Bookspan Basics) to teach your teams, squads, classes, students, kids, groups, battalions, etc.
Assemble your group in neat rows. Stand in front in view of all. Tell them this is a basic, functional physical skill to reduce musculoskeletal injuries, that puts together the first and second skills, previously learned:
Tell everyone to crouch using good bending (knees do not sway inward or slide forward, taught in the first skill), then rise to toes with stable neutral ankle (not bowing outward at the side, taught in the second skill).
Next, have everyone bend and rise increasingly rapidly and smoothly, in a jumping motion, first without rising from the ground, then barely jumping. With each bend and rise, they maintain good knee bending and neutral ankle. Repeat 10-100 times, depending on time and needs.
Next, tell everyone to jump, landing softly using thigh and hip muscles for shock absorption, and good knee bending and neutral ankle. Start jumping moderately, then work for increasing height with each repetition. Repeat 10-100 times, depending on time and needs.
Use conscious control to prevent inversion sprains and turns by not allowing the ankle to invert (turn sideways) when rising to toe during push-off in running and jumping, and coming down during landings. Watch for healthy ankle and knee stability and placement throughout the team season.
Each new Functional Training exercise shows how to teach your groups (or self) how to prevent common musculoskeletal problems during the team season or operational theater. Learn this one to be ready for an upcoming FFT, needed for cutting, changing direction, lateral movement, more.
Trainers, Drill Instructors, readers, send in your stories of how you use these in your program.
Good body mechanics are a powerful performance enhancing aid.
--- Read and contribute your own success stories of these methods. Before asking questions, see if your answers are already here - click labels under posts, links in posts, archives at right, and the Fitness Fixer Index. For answers to personal medical questions - Replies to Medical Questions. Subscribe to The Fitness Fixer, free. Click "updates via e-mail"(under trumpet) upper right. See Dr. Bookspan's Books, take a Class, get certifiedDrBookspan.com/Academy.
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Use conscious control to prevent inversion sprains and turns by not allowing the ankle to invert (turn sideways) when rising to toe during push-off in running and jumping, and coming down during landings. Watch for healthy ankle and knee stability and placement throughout the team season.![Reblog this post [with Zemanta]](http://img.zemanta.com/reblog_e.png?x-id=7f3cda12-f181-4c7a-9393-ff9d7b56df77)
