Supportive Hard Shoes Linked to Knee Loading and Arthritis
Tuesday, March 30, 2010
Jolie Bookspan, M.Ed, PhD, FAWM
A Rush University Medical Center study has found that supportive, stable shoes increases the load on the knee joints compared with flat, flexible footwear or going barefoot.
Researchers compared gait and knee joint loading of 31 patients with osteoarthritis while walking in flip-flops, barefoot, and wearing several types of popularly prescribed shoes. Clogs and stability shoes increased loads on the knee joints up to 15 percent over flat walking shoes, flip-flops or barefoot. Knee loading was roughly the same whether the subject wore flips-flops or walked barefoot.
Dr. Najia Shakoor, rheumatologist and lead author stated, "Stiffness is also a factor. We've shown in earlier studies that barefoot walking is associated with lower knee loads than walking with conventional footwear. It may be that the flexible movement of the bare foot is mechanically advantageous. The natural flex of the foot when it contacts the ground probably attenuates the impact on the joint, compared to the artificial 'stomping' movement created by a stiff-soled shoe."
"Clogs and stability shoes, conventionally believed to provide appropriate cushioning and support, actually increased the loading on the knee joints, as opposed to shoes with less 'support,' flatter heels and more flexibility."
The article stated, "A higher-than-normal load on the knees during walking is a hallmark of the disease, associated with both the severity of osteoarthritis and its progression."
Primary Source -Najia Shakoor, Mondira Sengupta, Kharma C. Foucher, Markus A. Wimmer, Louis F. Fogg, Joel A. Block. The effects of common footwear on joint loading in osteoarthritis of the knee. Arthritis Care & Research, 2010; DOI: 10.1002/acr.20165
Study authors felt they had to also issue a caution that people who will trip if they wear flip flops or have poor balance not to wear them, however it seems better to do simple function to improve balance and reduce cause of the falls rather than wrap people in shoe "straight-jackets" that are not good for them.
When I was small, I remember worrying that horses had to wear iron shoes. I asked the teachers in school if it hurt the horses' feet, and was told their feet don't feel anything (a myth). I asked if the metal increased the hard impact against paved streets and why didn't horses wear sneakers instead. I was told that sneakers were bad for you because they don't "support" (another myth). I asked why you needed anything to hold your own body up and why you couldn't have healthy feet without them. I asked if cavemen wore support shoes and incredibly, the teachers said that support shoes were important and barefoot was wrong and cavemen had to wear shoes or they would not be able to walk. Later I found that arthritis, lameness, and gait changes were higher in metal shod horses, and that new horseshoes were being made in urethane and other soft composites.
When I tell patients that hard supportive shoes are known to increase pain and problems, they say they wear them because their doctor told them to, their trainer, their aerobics instructor, and their physical therapist said they must. When I remind that hard shoes may be part of their knee and foot pain, they say that they got the shoes from their podiatrist or orthopedic shoe place. Doctors used to recommend smoking cigarettes for the several benefits they gave - calming nerves, better digestion. The two bad side effects (illness and death) were left out. It may be commonly repeated that you need hard supportive shoes however, untrue stories are common.
"Side note on plank and thinking. I have been trying to recite a kata narration (the moves of a karate sequence) from memory during a plank and find it incredibly difficult to concentrate. At first it was just plan different and difficult, now it seems to get difficult after 30secs. (the memory verbal part) It’s like I can feel my brain trying to multitask, and misfiring.
"I suppose this is a type of stressful concentration training and is good for the brain. Makes me wonder what other psychological/physiological benefits there may be."
Speaking a sequence or other specific chain of events at the same time as directing your body to do unrelated sequences requires a collection of concentration and focus.
Hold a plank
Recite the directions to your school or workplace, the steps of your martial arts forms, or other sequences
While still holding your plank, recite the steps backward
It takes intense practice before physical movements become automatic while mental focus is directed separately. This is a fun, wise, important, and functional thing to practice and train. Training automaticity is never an excuse to text and drive. The difficulty of this training drill demonstrates why it results in so many accidents.
Coming soon: Taking this to the next step for more physical concentration training
Surgery For Achilles Tendon May Not Improve Recovery
Thursday, March 25, 2010
Jolie Bookspan, M.Ed, PhD, FAWM
Readers have been asking about fixing Achilles tendon tears. They ask if tears can heal without surgery. Tears, even complete tears, can heal with the right rehab therapy even without surgery. A recent study of 92 patients made news when it concluded, "Surgical and nonsurgical treatment were equally effective for patients with acute rupture of the Achilles tendon."
Dr. Katarina Nilsson Helander, MD, of Kungsbacka Hospital in Sweden reported at the March 2010 American Academy of Orthopaedic Surgeons meeting, that outcomes and rates of re-rupture did not differ significantly through 12 months between patients getting surgery and those with physical rehab alone. Within 72 hours of injury, the 97 patients were randomized to surgery (48 patients) or no surgery (49 patients), followed by two weeks in a firm cast, then six weeks in an adjustable brace that allowed some movement of the foot. Both groups reported increased physical activity over time. All underwent identical rehabilitation programs. Complications in the surgical group included one contracture of the tendon, two wound infections (one deep and one superficial), and two nerve disturbances. Thirteen patients had concerns about the scar, 10 for cosmetic reasons and three for scar contracture and pain. Both groups were still below pre-injury levels at one year.
Primary source: American Academy of Orthopaedic Surgeons. Nilsson Helander K, et al., "Acute Achilles tendon rupture: an RCT comparing surgical and nonsurgical treatments" AAOS 2010; Abstract 712.
There is currently no consensus whether surgery plus physical rehab, or physical rehab alone is the favorable approach. That means, if you go to a doctor with your Achilles tear, you may be told that surgery is the only way, even though you may get the same results without the surgery. Many people hope to have surgery and be done with their problem, not knowing they will need the same physical therapy either way. Complications such as incision-healing difficulties, infection, contractures, re-rupture of the tendon, atrophy, complications and illness from anesthesia, bleeding, clots, scar pain, nerve pain, can arise from surgery. Drugs required during and after surgery can create new illnesses and further drug prescriptions. Surgical and healing outcomes vary with the skill, luck, and patient load of the operating team that day.
It is not new information that surgery may not always be required. Several studies conclude that non-surgical treatment yields similar results:
Fruensgaard S, Helmig P, Riis J, Stovring JO. Conservative treatment for acute rupture of the Achilles tendon. Int Orthop. 1992;16(1):33-5.
McComis GP, Nawoczenski DA, DeHaven KE. Functional bracing for rupture of the Achilles tendon. Clinical results and analysis of ground-reaction forces and temporal data. J Bone Joint Surg Am. 1997;79(12):1799–808.
van der Linden-van der Zwaag HM, Nelissen RG, Sintenie JB. Results of surgical versus non-surgical treatment of Achilles tendon rupture. Int Orthop. 2004;28(6):370–3.
Soccer player David Beckham underwent surgery last week after tearing his left Achilles' tendon playing for AC Milan against Chievo. The news reported that the surgeon, Dr. Sakari Orava, said that, "The operation went smoothly and nicely" but that Beckham would not be able to play in this year's World Cup, saying "No,....healing (from the surgery) takes a long time."
Big thanks to the blog Suture for a Living for hosting Grand Rounds Vol 6, No 26 and including two of my articles among the votes for best medical writing of the week. Both Grand Round choices are reader success stories from Peggy Santamaria, who is bringing my healthy daily life techniques to developmentally disabled adults:
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.
Congratulations Ms. Santamaria, and thank you Grand Rounds for bringing her work to the medical audience.
Functional Fitness as a Lifestyle By Mail Room Workers
Monday, March 22, 2010
Jolie Bookspan, M.Ed, PhD, FAWM
Peggy Santamaria wrote me that she was using my work, and my illustration Backman!™ to teach healthy movement to workers for a good day's work without injury and repetitive strain:
"Hi Dr. Bookspan, "Very excited to report that I met with the Appalachian Crossroads staff and the trainees of the Mail Room Service Unit. The goal is to connect developmentally disabled adults with a paycheck for good work done well.
"I had created some Backman!™ flash cards illustrating some of the daily work in the mail room. These were distributed to the trainees with explanations for the staff about our new program. Then I met with the trainees and talked more about functional fitness.
"We then practiced some of the healthy movements needed for their work day. We took pictures to document their great understanding of what we are working toward. I will make these photos into small posters that can hang in their workspace.
"They are all excited about what we are doing and are proud to be part of the Academy. "Peggy"
Here is Ms. Santamaria's update with the successful outcome plus great photos. I personally congratulate and thank each participant:
"Hi Dr. Bookspan:
"Here is an update on Academy activity. As you know, I am working with staff and trainees at Appalachian Crossroads, a private nonprofit human service agency that primarily serves developmentally disabled adults in Garrett County, Maryland.
"One of the Appalachian Crossroads work units provides a "mail room" service to local businesses. The trainees in the mailroom provide support, expertise, and manpower to process everything from daily statements to sales catalogs to monthly newsletters. More than 1.2 million pieces of mail go through the hands of 18 employees each year.
"As the Academy’s director of Developmental Abilities I set about creating a program using your work and Fitness Fixer to help the trainees work in a healthy way and be functionally fit. I met with staff and trainees of the unit to hand out instructional flash cards featuring Backman!™ going through the daily functions required in the mail room.
"The Appalachian Crossroads folks were super. They got right to it. With the help of staff they were ready to work and demonstrate their functional fitness skills. I took pictures that I am making into small posters for their work area.
"I will continue to work with these men and women as well as others in the custodial service unit, the grounds crew, supported employment, and the day program. It is a privilege to be working for the Academy and sharing your fitness message. "Peggy Santamaria"
This is a shining example of getting things done well, simply, and intelligently. Thank you Peggy! Thank you Appalachian Crossroads staff and mail room!
Readers, The Mail Room is teaching us how to keep things healthy and smart. They are role models and generous guides for all of us. Use what they have done, and send your stories of using this work for Good.
Day and night will be approximately equal length today, March 20 2010 at 1:32 PM EDT. That event is called the equinox, meaning "equal night." In the Northern Hemisphere, it marks the beginning of Spring. Each day after the equinox will be longer and each night shorter until the longest day of the year at the solstice in June when summer begins. In the Southern hemisphere, this March equinox marks the beginning of Autumn, where days will be shorter until the solstice in June marking the beginning of the Southern winter.
Fitness Fixers For Spring Training, Exercise, Cleaning, and Celebrating:
Here is Fast Friday Fitness - Strengthen your arms while learning to change a movement habit that is a common source of elbow pain:
Hold a pushup or plank position, handstand, or just lean on one or both arms.
Notice your elbows. Check if you lock them straight, or let them hyperextend (bend slightly backwards) shown in the photo below.
Instead, keep elbows slightly flexed (bent forward). You will feel an increase in arm muscle use.
The elbow joint is called a hinge joint. It is shaped to open and close like a door. Because of the shape of the bones, opening wider than a certain point - usually close to a straight line - is stopped by the bones, not muscle flexibility. You can try it yourself now, and feel the bony end point. Like a door, if you force the elbow joint open past maximum straight range, it yanks one side of the hinge and squashes the other. Don't try that yourself. That is a common injury in yoga because some forms of yoga teach to hyperextend the elbow under body weight.
People with flexible elbows, both men and women, have bones shaped to open slightly wider. They can hyper-extend the elbow so that it bends slightly backwards. That is not a disease or cause of pain by itself and does not preclude them from sports like archery as often repeated (will be covered separately). You can easily control elbow angle using your brain and muscles.
For leaning against a counter, bike handlebars, doing pushups, plank, yoga, and other leaning or arm balancing. Keep elbows slightly flexed instead of letting the joint open to or past maximum range.
Giuliano is a young Romanian boy living in Italy, trained by his gymnast father. Thank you reader Paul J for telling me about him.
Below is a link to the short video clip where I captured the above photos. I was not able to embed this movie, by request at the source. Click to watch 5 year old Giuliano do air pushups:
I used to teach air pushups in my yoga classes. Every class gave opportunity to see, try, and learn. I'd coach, encourage, even lift the students personally if it helped them try it, or feel the leverages needed. Were students excited? Inspired? Did they get strong and focused?
They might have if they tried it. They whine, stall, pout, refuse, and complain to management that my class is haaaard, and they had to connnnnnn-centrate. They didn't want any of that.
Each week new students arrive in my yoga class, holding expensive yoga equipment. Some are yoga instructors. They explain to me that yoga cures all back pain. I ask why they have come and they tell me all about their back pain that they have for 4 years and they do yoga every day (not curing anything evidently). They say they do yoga all the time and know all about it and how it gives you peace and love and concentration and good posture and strength and balance. Then they sit in terrible posture waiting for class. They get indignant when I tell them to sit well. They correct me that "class hasn't started yet." In the first minutes of class I teach standing on one leg. They topple over and refuse to try again. I have them stand on the other foot and they are flabbergasted that we are doing it again when they just spent all that time insisting to me that they can't (instead of trying). We do simple planks and they sag their back and lock their elbows. When we start hand balancing to learn the basics of air pushups, some of these yoginis have thrown full-out tantrums.
Then the next week, a new crop comes to class explaining to me that yoga gives you love and acceptance and peace and good posture. So I teach them air pushups.
Giuliano also does The Flag - To be covered in the future.
Ivy from New Zealand continues making her community healthier, one neighbor at a time. What does she do that helps so many? Here are just a few stories from her many updates:
"Yesterday, I was talking to a 64 year old woman who is a new resident to this country and she told me that she was experiencing back pain. I told her that I could help her - she was most insistent that she hated exercise so I promised that I would not have her exercising that what I would show her would be what she could do as she went about her daily life. I showed her how to lie on the floor and lift herself up on her elbows. She marveled at the instant relief. I then showed her how to squat and do lunges which she was most receptive to. I showed her how to sit up straight, shoulders back and suggested that she lift her ribs (to learn to unround the upper back instead of forcing the straightening from the shoulders or neck). I was most amused she put her hands over her rather ample breasts and lifted them up. It looked so funny. It is the first time I have had someone do that to lift her ribs."
In January 2010, this update came:
"Just the other day when I spoke to Jean she remarked how young I look. (Jean is the lady who I helped re back pain) She said that she felt envious when she compared herself at 62 with me at 73. I remarked that I could not help but be surprised as all I see are the wrinkles when I look in the mirror. No, she replied, we all get wrinkles, it is your slim, fit body plus the fact that you walk so fast. So........., there is hope for me yet!!!!! Smile, "Hugs to you both "Ivy"
In January, Ivy sent me a happy e-mail. The large-chested neighbor who thought pain was due to her size was able to stop upper back pain with healthy techniques, and holding her weight in healthy positioning on her muscle, rather than letting shoulders round and slouch in painful position:
"Jean tells me that she is now free of back pain. She is lying down on her stomach lifting herself up on her elbows on a daily basis. Needless to say she is very happy with the results.
"Re the trapezius and pectoral stretch - she will be visiting me over the next few days (to check good positioning learned from it).
"Re: Merlene (Strengthen a Neighbor, Strengthen a Community) - I did not have to telephone Merlene, she called me to ask if I could vist her. She showed me how well she was doing re her balance. Also, she was delighted re her weight loss. I checked her posture and it was perfect. No longer any back pain.
"She asked if I could help re strengthening her legs. I showed her how to do lunges.
"Merlene is always a pleasure to work with. She is a delightful lady. Love and hugs to you both Ivy"
At the end of January Ivy wrote again:
"Jean: I visited her at home this morning to show her both the Pectoral and Trapezius stretch. She tells me that she no longer has any pain in her back and hip. She also tells me that she has shown her daughter the back stretch and she, too, no longer has any back pain. So.........two very happy women.
"Merlene: I also contacted Merlene this morning to see how her lunges are going. She, too, is happy with her progress.
"Jean did make a comment as to how much I could help people here in the village. I replied that I do try, however, the request has to come from them personally. It is all a matter of choices. Some choose to take medicines, others do not (and use healthy ways to fix the pain without needing medicines).
"Love and hugs to you both Ivy"
February brought this:
"Over the weekend, I received an e-mail from a friend who lives in Australia, telling me that she had back ache. She had had it for a week and had decided that once the weekend was over, she would go to the doctor to get some pain relief.
"I wrote back and told her to lie on the floor or bed and lift herself up on elbows. I have just received a reply saying that the pain has gone.
"Today while shopping in my local organic shop I got talking to a lady who had decided that she would shop for healthy foods instead of the usual junk food. She explained that her family had minor health problems and thought that perhaps if she changed their diet, the health of the family would improve. She noticed what I had in my shopping trolley so asked if I would mind helping her. Actually, I must admit that I did enjoy doing so. She could not believe the knowledge that I was able to pass on and was most grateful. One of the things she asked was how to make sprouts. Not a problem I replied and explained how I, personally, do sprouts. I hope I see her again soon so I can catch up on their progress.
"My shopping which usually takes 20-30 minutes took more like an hour and a half. I assure you, it was time not wasted.
"Hugs Ivy"
Does Ivy meet people who work against themselves? Last October she wrote me about one:
"Thank you for the post re helping oneself. I must have missed your post "Somebody Please Do My Personal Responsibility For Me." (my computer would have been out of action) To be honest, I could not help but burst out laughing at some of the excuses, as I, too, hear these same words time and time again.
"As an example, about 3 years ago, a lady approached me for help re her weight. I might add that she was morbidly obese.
"I wrote her out what I believed to be a balanced diet with plenty of food so that she would not feel hungry. She was thrilled to see that she had lost 16 lbs when I weighed her the following week. For the next few weeks there were no weight losses at all. I asked her if she was following the diet. No, was her reply, you allow me too much food, so I cut down on the quantities. I then get hungry and eat what I shouldn't. This went on for 6 weeks.
"Needless to say, I gave up on her.
"This same lady now lies in bed all day. She does no exercise what so ever. Her husband does everything for her. Once in awhile I see her go out with her husband in the car.
"It is so sad. I did but try. No doubt you can tell many similar stories.
"Have a great day "Hugs, Ivy"
Wisely, Ivy has focused her energy on others since.
Here is Friday Fast Fitness - great concentration, body strength and endurance for almost everything, healthful family fun, and improving your chess game, all at once. Reader Paul J wrote in with this:
"Dr. Jolie, "Have you and your husband ever tried to play chess and do the plank at the same time? "Well, my son and I tried last night and my plank failed first so I lost. "Plus, my opening moves were bad , so I ended up losing the game twice. "Not quite Chess Boxing, but easy to try at home. PJ"
Give a try:
Face the board. Hold a neutral spine push-up position called the plank.
Hold while you play, at least for your turn.
Winner can be determined by moves alone, or the player who maintains their plank.
Use this as a model for straight position while raising your arm to move your chess pieces.
Paul J wrote:
"I was thinking doing the plank for the whole game may only be possible by a few people. "However it should be possible to do the plank during your turn and the opponent gets to rest. "This encourages faster play (my original intent) and of course exercise and working at concentration."
I wrote back asking Paul J and his son to get some photos. While they do that, readers please try it and send in your own - of Chess, other board game you like, or other great ideas that you have.
David Williams, co-founder of MedPharma Partners LLC, who writes the Health Business blog, wrote, "Got back pain? Exercise is the only thing that seems to work. From the Fitness Fixer."
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 David William, this week's host, for doing the hard work of collecting and featuring our articles.
New Healthy Employment Programs for Developmentally Disabled
Monday, March 08, 2010
Jolie Bookspan, M.Ed, PhD, FAWM
Another reader has Fixed the Fitness for a community program so beneficial and potentially far-reaching that I have given her an Academy Appointment.
Peggy Santamaria is bringing my healthy daily life techniques to developmentally disabled adults. She has made a new program to transition developmental disability to Developmental Ability.
"Thanks. Cool to find that this morning on Fitness Fixer. I would like to work with job coaches at a local agency that trains and finds employment for developmentally disabled adults. Snow removal is one of their big programs. I hope I would have your permission to use Fitness Fixer techniques to help prevent injuries for these trainees. I am on the board of directors for the agency and really support the program. Thanks again. you rock!!!" peggy
I wrote back asking if she could start before the snow season ends, which was soon, and that when the snow season ends, what activities and healthy movement retraining could she bring to them?
Peggy replied:
"Just spoke with program director at Appalachian Crossroads. I will meet with his job coaches and staff on Monday afternoon to talk about healthier movements while on the job shoveling snow, landscaping, vacuuming, etc. This is their website if you want to check them out, www.appalachiancrossroads.com/"
I am pleased to announce her appointment through the Academy of Functional Exercise Medicine (AFEM) as Director of Developmental Ability. We are working on better names - write in your ideas in the comments for a good title for this program for the disabled to develop their abilities. Peggy has been working hard developing the program. She drew the shovels for me for the Backman!™ illustration, and has been drawing and developing more teaching tools.
Our plan is for participants to gain skills and healthy work, reduce injury and pain risk, and be proud role models. The community gains important improvements in ways that are healthy for all. We hope our program with Appalachian Crossroads becomes a model for programs all over the nation like it.
Peggy wrote back:
"WOW!!! That's all I can say. Off to teach a class. I have read a gazillion of your fitness fixers (they are like peanuts, you know). I just don't get any housework done. But I will be well-armed to begin this task.
"My daughters and grandchildren are very proud. (They) said it was "awesome" and "Go Grandma Peggy!""
Join TheFun - Join in this work, and do the same for your own local world. Send in your own ideas and stories. See my Academy page - www.DrBookspan.com/Academy.
Fast Fitness - How To Find The Most Recent Fitness Fixer
Friday, March 05, 2010
Jolie Bookspan, M.Ed, PhD, FAWM
Here is Fast Friday Fitness - What does the blue underlined link calledThe Fitness Fixer at top left do?
News feeds and RSS aren't working for many readers again. No problem. If you have missed some articles, or are reading a previous article, an archived article, or were sent a link, here is how to find the current articles and others:
Any time you are reading any Fitness Fixer, look to the top left for the large blue underlined title The Fitness Fixer. It is a link to the page that loads the current article, plus several previous.
To see articles previous to the one you are reading, look for gray banner to the right called Recent Posts. It is the list above the Archives.
Achives give all articles in a specific month. If you want the current month and it is not yet in the Archives, click the blue underlined title The Fitness Fixer at top left.
Instead of putting photos of this here, you can try it yourself right now with the real thing.
If you are not already on the Fitness Fixer site, use the URL for the Fitness Fixer main page:
Reader Peg S. put healthy bending to work in real life, wrote in with this success story, sent a title for it, took photos and sent them with captions. Thank you Peggy for great work:
"Dr. Bookspan, your emphasis on squats and lunges in place of unhealthy bending has saved my back during long hours of snow shoveling.
"Lots of snow has fallen in far western Maryland - over 265 inches so far this season - with three back-to-back blizzards (22 feet of snow, or 673.1 centimeters).
"All that snow needed to be moved. I avoided unhealthy bending and had no back discomfort after hours of lifting snow-laden shovels.
"When I took a break, I emailed my yoga class students reminding them of the healthy movements such as squat and lunge in their snow removal efforts. They later thanked me for the reminder.
"Thank you for the information on back health!!!" Peggy S
Peggy is teaching these and other healthy movement techniques to developmentally disabled adults to train useful work skills and prevent injuries. See the first results in Functional Fitness as a Lifestyle By Mail Room Workers Peggy, her colleague Patty, Reader Paul J, and I have been working on Peg and Patty's project of using human powered devices like bicycles, to make electricity. More on this to come. Contact me if you can offer real input to design or build.
Thank you to the blog Dr. Anonymous for collecting and listing the best medical writing of the week for Grand Rounds Volume 6 number 23, and including my article How Many Sets And Reps Does It Take?
In a hospital, Grand Rounds is a lecture for doctors about a patient or topic. On the web, a different Grand Rounds host works hard each week to find and list the best in recent medical articles. Click How Many Sets And Reps Does It Take? to see this week's Grand Round article from Fitness Fixer.
Readers wrote in with questions, showing common myths about lactic acid.
Jens wrote that his yoga teacher told him, "The reason he wakes up with stiff muscles is lactic acid build up during sleep." Reader Trish said her aerobics trainer said she must never work above her lactate threshold or she will not make gains. Reader Yash wrote that his massage therapist says he "has lactic acid build up, making little balls in his muscles... that continuously stay there for some reason." During TV coverage of the 2010 Winter Olympic Games, a television news show talking about Olympic training stated that a skier used a secret new method to reduce lactic acid between races.
None are true.
For Jens' question: You do not elevate or accumulate levels during sleep, it takes hard exercise. Lactate is not related to stiffness on waking. Muscle and joint morning stiffness is usually from not moving. It is normal to move change position a bit during sleep, but it is still greatly reduced motion. Lactate levels rise (not lactic acid) when you are exercising. Exercise during the day is important for muscle and joint health. Increased lactate during exercise does not cause stiffness - that is another myth. Delayed stiffness in the days after exercise is from other causes.
For Trish: Working above threshold is useful training. It increases physical ability by itself and makes physiologic changes that raise the existing level. Lactate only builds when you are exercising hard. Making lactate with hard exercise is a good and healthy thing.
For Yash: Lactate levels do not stay elevated in the body, whether at exercise or rest. When you exercise, body processes remove it almost as fast as you produce it. The "almost" is a good thing. Some is removed to make other products, and the extra is used as an important fuel for your heart and other muscles. Even when levels rise during exercise, it does not form a solid and cannot make lactate balls.
The television news show, 2020, aired a segment on February 26th about Olympic training. They stated that a skier "used a secret new method to reduce lactic acid between races." The secret was stated as "spinning." It is long known that activity reduces lactate faster than total rest (lying down). It is not specific to biking or spinning. Any mild activity works. It is not a new training technique or a secret. Reducing lactate levels between bouts of exercise using lighter exercise is sometimes called "active rest." That sounds like a funny name, until you remember that to athletes, doing light exercise is like resting.
Lactic acid and lactate are different. To be covered separately.
I have never personally seen a lactate molecule by itself, and neither had any of my professors in school who taught me about lactate and lactic acid. I think that none of the people telling readers these myths have seen a lactic acid molecule. What I was able to do is directly personally measure lactate in different people, in individual body areas, during and after exercise, and at rest, to be able to see for ourselves.
--- Read success stories and send your own. See if your answers are already here - click Fitness Fixer labels, links, archives, andIndex. Subscribe free - updates via e-mail or RSS, upper right. For personal medical questions - Replies to Medical Questions. Limited Class space for personal feedback. Top students may earn certification throughDrBookspan.com/Academy. Learn more in Dr. Bookspan's Books.
When I was small, I remember worrying that horses had to wear iron shoes. I asked the teachers in school if it hurt the horses' feet, and was told their feet don't feel anything (a myth). I asked if the metal increased the hard impact against paved streets and why didn't horses wear sneakers instead. I was told that sneakers were bad for you because they don't "support" (another myth). I asked why you needed anything to hold your own body up and why you couldn't have healthy feet without them. I asked if cavemen wore support shoes and incredibly, the teachers said that support shoes were important and barefoot was wrong and cavemen had to wear shoes or they would not be able to walk. Later I found that arthritis, lameness, and gait changes were higher in metal shod horses, and that new horseshoes were being made in urethane and other soft composites.
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