Archive for October, 2011

The Key to Ankle Sprains May Be in the Hips and Knees

If you want to avoid an ankle sprain – one of the most common injuries seen at sports medicine clinic – the key may be in your hips and ankles.

A new study by Georgia kinesiologists suggests that movements at the knee and hip joints may play a role in ankle sprains as well.

“If you have ankle sprains, you may have a problem with the way you move, and we think we can change movement through rehabilitation,” said Cathleen Brown, assistant professor in the department of kinesiology in the College of Education.

She is the lead author of the study published in the early online edition of the journal Clinical Biomechanics.

Previous studies on ankle sprains have shown that some people return to sports or physical activities without a problem.

The Georgia researchers set out to find out know why some people recover completely, and others do not.

They put 88 people into an Avatar-like body suit that sent data to cameras and computers detailing the exact position of ankle, knee, and hip joints.

The participants jumped off an in-ground metal platform and landed on one foot without assistance.

The key finding had to do with the landing.

Those who had uninjured ankles bent their knees and swayed their hips side-to-side more often than either of the other groups.

Those who had sprained an ankle but no longer felt pain or weakness also showed movement in those joints.

A group with lingering ankle pain appeared unable to use their knee and hip joints as well when landing on the metal surface.

“Maybe the injured people don’t use the same landing strategies, or their strategies aren’t as effective,” Brown said.

She noted that “we don’t know if they are this way because of the injury, or if they got this injury because they land this way.”

The next step is to examine the 3 joints in combination and possibly identify the particular movement patterns that could translate into new rehab techniques for ankle sprains.

There already is a precedent in preventing knee injuries.

A number of studies have unequivocally demonstrated that female athletes who participate in jumping and cutting sports are about five times more likely to sustain serious knee injuries than males.

Biomechanical studies have shown that female athletes have decreased neuromuscular strength and coordination in the muscles that stabilize the knee joint, which may be responsible for this injury increase.

Now a variety of “jump training” programs have been designed to show female athletes how to jump, and land, better so that they can increase their hamstrings strength and improve the ability to control dangerous forces at the knee.

Living Testament to Top 10 Fitness Trends

I’m a living testament to the top 10 fitness trends.

For the past 6 years, the American College of Sports Medicine (ACSM), which is the largest sports medicine and exercise science organization in the world, has conducted an annual survey of health and fitness professionals worldwide designed to reveal trends in various fitness environments.

This year the 2,620 respondents chose the following top 10 fitness trends for 2012:

1. Educated and experienced fitness professionals. Given the large number of organizations offering health and fitness certifications, it’s important that consumers choose professionals certified through programs that are accredited by the National Commission for Certifying Agencies, such as those offered by ACSM.

2. Strength training. Strength training remains a central emphasis for many health clubs. Incorporating strength training is an essential part of a complete physical activity program for all physical activity levels and genders.

3. Fitness programs for older adults. As the baby boom generation ages into retirement, some of these people have more discretionary money than their younger counterparts. Therefore, many health and fitness professionals are taking the time to create age-appropriate fitness programs to keep older adults healthy and active.

4. Exercise and weight loss. In addition to nutrition, exercise is a key component of a proper weight loss program. Health and fitness professionals who provide weight loss programs are increasingly incorporating regular exercise and caloric restriction for better weight control in their clients.

5. Children and obesity. With childhood obesity growing at an alarming rate, health and fitness professionals see the epidemic as an opportunity to create programs tailored to overweight and obese children. Solving the problem of childhood obesity will have an impact on the health care industry today and for years to come.

6. Personal training. More and more students are majoring in kinesiology, which indicates that students are preparing themselves for careers in allied health fields such as personal training. Education, training and proper credentialing for personal trainers have become increasingly important to the health and fitness facilities that employ them.

7. Core training. Distinct from strength training, core training specifically emphasizes conditioning of the middle-body muscles, including the pelvis, lower back, hips and abdomen – all of which provide needed support for the spine.

8. Group personal training. In challenging economic times, many personal trainers are offering group training options. Training two or three people at once makes economic sense for both the trainer and the clients.

9. Zumba and other dance workouts. A workout that requires energy and enthusiasm, Zumba combines Latin rhythms with interval-type exercise and resistance training.

10. Functional fitness. This is a trend toward using strength training to improve balance and ease of daily living. Functional fitness and special fitness programs for older adults are closely related.

Last Spring, my wife and I bought a series of personal training sessions with certified pros (#1) at both of our kids’ respective school fundraisers.

My plan is ask one of these personal trainers (#6) to set up a general strength training program (#2), in particular working on my upper body strength so I can continue to carry home a case of seltzer from the beverage store a few blocks away (#10).

I’d like to specifically work on core training (#7), which I think will help with turning my waist during the Tai Chi classes I take twice a week at my local Y, mostly with other baby boomers (#3).

I’ve become much more aware of portion sizes recently with my wife on a weight-loss program, and with my doctor’s encouragement, I’m doing aerobics for 30 minutes about twice a week (#4).

One of the issues I follow regularly is childhood obesity (#5) and I blog about it often.

Okay, so I don’t do Zumba classes (“I won’t dance, don’t ask me”) and I’d rather work one-on-one with a personal trainer than in a group.

But the fitness pros pretty much got it all right in their predictions for next year’s top trends.

Getting Fit in School, But Not in Gym Class

Most kids don’t get enough exercise, in school or out.

This great fitness article demonstrates how creative New York City teachers can be to make up for the lack of gym classes in public schools.

Research shows there is a real link between quality physical education and present and future physical activity participation.

The state mandates that city students get a certain amount of exercise: every day for kindergarten through 3rd grade, for at least 120 minutes a week; 3 times a week for grades 4 through 6, also for a minimum of 120 minutes; and at least 90 minutes a week for grades 7 and 8.

But the Department of Education is failing gym, said City Comptroller John C. Liu.

An audit of 31 elementary schools throughout the city found that none were in full compliance with the state guidelines on physical education.

High school students should get 225 minutes per week, according to the National Association for Sports and Physical Education (NASPE).

Sadly, according to a NASPE report, about two-thirds of high school students don’t get the recommended levels of physical activity that increases their heart rate and makes them breathe hard some of the time for a total of at least 60 minutes per day on 5 or more days a week.

Some city educators have found innovative ways to make up for lack of gym class.

Among them are:

a free before-school running program sponsored by the New York Road Runners

after-school fitness clubs

having students stretch or do simple calisthenics at their desks

practicing yoga for a few minutes before a test

These educators should be applauded for getting students up and moving.

As guidelines from the federal Health and Human Services recommend, no period of moderate- or vigorous-intensity activity is too short to count toward the recommended daily activity.

The most obvious teaching lesson, of course, is the importance of being physically active throughout life, starting at a young age.

Gastric Bypass Helps the Whole Family Lose Weight

One of the biggest risks for becoming an obese child is having an obese parent.

But what happens if an obese parent makes the changes necessary to lose weight?

What if that includes undergoing gastric bypass surgery?

A new study shows that the obesity rate in children of mothers who have had Roux-en-Y gastric bypass is 52% lower after surgery compared with the obesity rate in children born to the same mothers before surgery.

“If one member of the family makes drastic lifestyle changes following surgery, it is possible that other family members will adopt similar healthy habits,” writes Gavitt A. Woodard, MD and colleagues from Stanford University School of Medicine in the October issue of Archives of Surgery.

The Stanford doctors observed the weight and lifestyle changes of 35 patients who had gastric bypass surgery as well as 35 adult family members and 15 children under age 18.

As expected, one year following surgery the patients undergoing gastric bypass surgery lost a typical amount of weight, the doctors say.

What’s more, all adult family members dropped an average of 22 pounds, from 220 to 198 pounds.

And obese children had a lower body mass index than was expected for their growth curve at the one-year follow-up.

How did the family members lose weight?

A year following surgery, both patients and adult family members made significant changes in their eating habits.

The gastric bypass patients also significantly increasing cognitive control of eating while decreasing uncontrolled and emotional eating.

Adult family members significantly decreased uncontrolled eating and emotional eating.

Additionally, children of the surgery patients were twice as likely to report being on a diet to lose weight one year post-surgery.

Children also benefited from fewer daily hours of television watching and increased hours of physical activity after a parent underwent gastric bypass surgery.

“Obesity is a family health concern,” say the Stanford doctors.

“This study demonstrates that performing a gastric bypass operation on one patient has a halo of positive effect on the weight, eating habits, activity level, and health behaviors of the entire family.”

In addition to purchasing food for the family, parents serve as role models for healthy behavior.

Parents who examine their own habits and make healthy changes, even ones as drastic as gastric bypass surgery, can play a significant role in the battle against childhood obesity.

Polycystic Ovaries Linked to Pregnancy Problems and Heart Disease

Polycystic ovary syndrome (PCOS) is one of the most common causes of women not ovulating and can lead to fertility problems.

PCOS has also been linked to pregnancy problems and heart disease.

Women with the condition typically have small cysts around the edge of their ovaries.

Symptoms include irregular periods, problems with ovulation, weight gain, and excessive hair growth.

Women with PCOS are also more likely to have fertility treatment.

A new Swedish study just reported online in the British Medical Journal indicates that women with PCOS are at increased risk of pregnancy complications, regardless of whether they are undergoing fertility treatment.

The nationwide study on 3,787 births among women with PCOS found these women were 45% more likely to experience pre-eclampsia (pregnancy–induced high blood pressure) and were more than twice as likely to give birth prematurely or to develop diabetes while pregnant.

Fertility is not the only health consequence these women face, however.

PCOS has been associated with an increased risk for cardiovascular disease (CVD), the leading killer of women and men alike.

PCOS has been associated with increases in artery-clogging triglycerides (fats) and insulin resistance, which boosts the chances for diabetes, a risk factor for heart disease.

“Some women need intervention based on existing guidelines, either to control their blood sugar to head off diabetes, or reduce their cholesterol to moderate the risk of premature heart disease.

For the rest, it’s a matter of treating each woman based on their individual needs,” said Sarah Berga, MD, former Chair of the Department of Gynecology and Obstetrics at the Emory University School of Medicine, at the “The Physiology of Cardiovascular Disease: Gender Disparities” conference held earlier this week at the University of Mississippi in Jackson.

“We know that PCOS puts these women at risk for CVD-related disease, but we do not yet understand the extent to which it does so.”

Experts recommend that women with PCOS be periodically screened for diabetes and treated for it if they meet certain formal criteria.

However, drug treatment to forestall diabetes has not been endorsed and it has not been established that giving women with PCOS metformin will delay or prevent diabetes.

Metformin is an oral drug used to manage diabetes, either alone or in combination with sulfonylureas or other agents.

Fertility experts often prescribe metformin to treat PCOS.

To identify whether an infertile woman who has PCOS will benefit from metformin, simple tests are performed to see whether she has insulin resistance, says Zev Rosenwaks, MD, director and physician-in-chief of the Center for Reproductive Medicine at the Weill Cornell Medical College in New York.

“If she does, then I prescribe metformin,” says Dr. Rosenwaks.

“Over 2 to 3 weeks, she slowly builds up to the usual dose of 500 milligrams of metformin 3 times daily or 850 milligrams twice daily with meals.”

If the woman does not start ovulating regularly over the next 6 to 8 weeks, then he initiates treatment with the ovulation-stimulating drug clomiphene.

About three-quarters of women with PCOS who are not ovulating will ovulate on clomiphene at some dosing level, and about half will become pregnant.

Back Pain Relief from a Herniated Disc

Back pain is second only to the common cold as a cause of lost days at work and it is one of the most common reasons to visit a doctor’s office or a hospital’s emergency department.

The good news is that most back pain will go away in a few weeks with some basic self-care.

But if pain is severe or lasts more than a couple of weeks, medical evaluation is called for.

“Back pain is not a disease but a symptom with many possible underlying causes,” says Dr. Andrew M. Peretz, a leading specialist in spine surgery with Somers Orthopaedic Surgery and Sports Medicine Group based in Westchester County, NY.

After strains and sprains, one of the most common causes of back pain is a herniated disc.

A herniated, or ruptured, disc is generally precipitated by years of wear and tear.

This occurs when a tear in the tough outer layer of cartilage allows some of the soft inner material to protrude out of the disk.

This is more likely to happen as you age and the discs weaken and become more prone to tearing, says Dr. Peretz.

The lower back (lumbar region) of the spine is the most common location of a herniated disc.

If the disc presses on the main nerve that travels down the leg, it can cause sciatica – sharp, shooting pain through the buttock and back of the leg – as well as tingling or numbness in the legs or feet and muscle weakness.

Most herniated discs resolve on their own or with conservative treatment, which includes rest, anti-inflammatory medication, and physical therapy.

Some people find that ice packs or moist heat applied to the affected area provide some relief.

“A day or two of rest is recommended,” says Dr. Peretz, “but no more unless you have severe pain.

Staying in bed too long can weaken the muscles and make the problem worse.”

Moderate walking and light activity may help, as well as exercises recommended by a physician or physical therapist that help keep your back muscles strong.

Exercises to maintain and develop your back muscles may include toe touches (with and without rotation), hurdler stretch, pelvic tilt, back extension, and hip extension.

If you do not respond to conservative treatment, an injection of a cortisone-like medicine into the lower back might help reduce swelling and inflammation of the nerve roots, relieving symptoms and improving mobility.

These injections are referred to as epidurals or nerve blocks and their effects sometimes last months.

Surgery is generally advised only for those who do not respond to other treatments, whose symptoms get progressively worse, or who experience progressive neurological decline.

It isn’t always possible to prevent the degeneration that induces a herniated disc but there are steps you can take to reduce your risk.

These include general best practices for good health: weight control, regular exercise and not smoking.

There are also some specific things you can do to promote back health:

Use proper lifting techniques.

Do not bend at the waist.

Bend your knees while keeping your back straight and use your strong leg muscles to help you support the load.

Practice good posture when walking, sitting, standing, and sleeping.

For example, stand up straight with your shoulders back, abdomen in, and the small of your back flat.

Sit with your feet flat on the floor or elevated.

Sleep on a firm mattress and sleep on your side, not your stomach.

Stretch often when sitting for long periods of time.

Do not wear high-heeled shoes.

High heel shoes cause you to lean forward and the body’s response to that is to decrease the forward curve of your lower back to help keep you in line.

Poor alignment may lead to muscle overuse and back pain.

“Most back and leg pain will get better gradually – usually within six weeks — by taking simple measures,” Dr. Peretz says.

“People with herniated discs generally respond well to conservative treatment and are able to return to their normal activities.”

Slice-Free Golf – How to Avoid the Dreaded Banana Ball

I can’t wait to play golf this weekend now that I’ve read Slice-Free Golf by Brian Crowell.

I met Brian, who is the PGA Head Golf Professional at GlenArbor Golf Club in Bedford Hills, NY, last Monday at a charity golf tournament, the FR Male Memorial Golf Classic, at Westchester Hills Country Club.

Part of the goodie bag was a copy of the Slice-Free Golf book.

Brian, who is also a golf analyst and commentator on television and radio, was on hand for a pre-round demonstration of his well-thought-out program to banish the “banana ball” — the golfer’s way of describing a slice.

In his easy-going, and amusing, style, he showed the 130 golfers how to set up, swing, and release the club to hit a gently curving draw, the opposite of a slice.

The one drill that struck me was his third-eye drill, where he placed a large eye on his chest and showed us how the third eye (and your chest) should point behind the ball at impact.

I spoke to Brian at the cocktail hour after the round, and he told me his easy-to-follow program “allows you to maintain your individual style, provides fast results, leads to permanent changes, and is 100% successful.”

He also counseled me how to avoid a golf injury:

“Don’t stretch until you have warmed-up and try to avoid hitting balls off a mat, which can be hard on a slicer’s hands and arms.”

I’ve now read through the entire book’s 25 drills and plan to put them into practice this weekend.

I’m hoping to avoid those slices from the rough that ended my team’s chances to win the Male tournament.

As Brian writes in the book, I’m now prepared “to hit shots that you wouldn’t have thought possible and get ready to have more FUN!”