Tag Archives: orthopaedics

bone health

Exercise and Bone Health

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Bone is living tissue that is constantly undergoing a process called remodeling. In remodeling, cells called osteoclasts are breaking down old bone, as cells called osteoblasts are replacing it with new tissue. Many factors can affect the remodeling process and leave you with bones that are less dense and more fragile.

Some factors that interfere with bone health and remodeling are:
• Increased age
• Low vitamin D—The body makes vitamin D in response to sunlight. You can also get vitamin D by eating certain kinds of food or by taking a supplement.
• A diet low in calcium
• Smoking
• Lack of exercise—especially weight bearing and resistance exercise

Why Exercise Is Good for Bone Health
Regular weight-bearing and resistance exercise helps build muscle, as well as maintain and increase bone strength. Exercise causes the muscle to contract against the bone. This action stresses or stimulates the bone, and the bone becomes stronger and denser. The 3 main types of exercise are (some activities can be more than 1 type):

Aerobic (Cardiovascular) Exercises to Improve Bone Health
In aerobic exercise, you continually move large muscles in the legs, shoulders, and buttocks. This action causes you to breathe more deeply, and your heart to work harder pumping blood, thereby strengthening your heart and lungs. Examples include:
• Walking
• Jogging
• Running
• Aerobic dance
• Bicycling
• Swimming

Weight-Bearing Exercises to Improve Bone Health
In weight-bearing exercises, your bones and muscles work against gravity, and your feet and legs bear the weight. Your bones adapt to the weight and pull of the muscle during weight-bearing exercise. Examples of weight-bearing exercises include:
• Jogging
• Walking
• Stair climbing
• Dancing
• Soccer

Resistance Exercises to Improve Bone Health (Strength Training)
Resistance exercises use muscle strength to improve muscle mass and strengthen bone. Examples include:
• Weight lifting, using:
• Free weights
• Weight machines
• Elastic tubing

• Calisthenics such as push-ups and chin-ups

tennis guy

Tips for Beginning:
Aerobic or Weight-bearing Exercises to Improve Bone Health
• Warm up for 5 minutes before activity. This can consist of dynamic stretches that involve movement and a light walk.
• Start the activity slowly for the first 5 minutes.
• Slowly increase your intensity so that your heart rate increases. A person doing moderate-intensity aerobic activity can talk. A person doing vigorous-intensity activity cannot say more than a few words without stopping to take a breath.
• Gradually increase your workout until you are working out at least 150 minutes a week at moderate–intensity or 75 minutes a week at vigorous intensity.

Resistance Exercises to Improve Bone Health
• Begin each exercise with light weights and minimal repetitions.
• Slowly (over weeks) increase weight, never adding more than 10% in a given workout.
• Do these exercises 2-3 times a week. Allow for 1 day between each workout for your bones and muscles to rest and repair themselves.
• Gradually increase the number of repetitions to 2-3 sets of 8-10 repetitions with a rest period of 30-60 seconds between sets.
• Although stiffness the day after exercise is normal, if you are in pain, you did too much. Decrease the intensity or the duration of your exercise.

Before starting any type of exercise program, check with your doctor about any possible medical problems you may have that could limit your ability to exercise.

by Mary Calvagna, MS

RESOURCES:
National Osteoporosis Foundation
http://www.nof.org

The President’s Council on Physical Fitness, Sports, and Nutrition
http://www.fitness.gov

CANADIAN RESOURCES:
Canadian Orthopaedic Foundation
http://www.canorth.org

Public Health Agency of Canada
http://www.phac-aspc.gc.ca

REFERENCES:
2008 Physical Activity Guidelines for Americans. US Department of Health and Human Services website. Available at: http://www.health.gov/paguidelines/guidelines/default.aspx#toc. Published October 2008. Accessed January 21, 2016.

Bone remodeling. University of Washington website. Available at: http://courses.washington.edu/bonephys/physremod.html. Updated March 30, 2007. Accessed January 21, 2016.

How much physical activity do adults need? Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/physicalactivity/everyone/guidelines/adults.html. Updated June 4, 2015. Accessed January 21, 2016.

Osteoporosis. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated October 13, 2015. Accessed January 21, 2016.

Skeleton keys. Smithsonian Museum of Natural History website. Available at: http://anthropology.si.edu/writteninbone/young_old.html. Accessed January 21, 2016.

Last reviewed January 2016 by Michael Woods, MD

EBSCO Information Services is fully accredited by URAC. URAC is an independent, nonprofit health care accrediting organization dedicated to promoting health care quality through accreditation, certification and commendation.

aquatic therapy

Is Aquatic Therapy For You?

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Aquatic therapy offers an alternative environment for therapeutic exercise. If you have tried traditional physical therapy, or have restrictions on your physical therapy program, aquatic Therapy may be the perfect solution for your physical therapy needs.

Why Aquatic Therapy is Beneficial

Less pressure: The buoyancy of the water decreases the amount of pressure, or compressive forces, on your joints and spine. When you’re immersed in water up to your neck, the weight pressing down on your body is reduced by 90%. When the water is up to your waist, the pressure is reduced by 50%.

Reduced swelling: The pressure of the water helps to move fluid from the injured area back into the body. Decreased swelling is essential for regaining the strength and motion needed for recovery.

Ease of movement:
Water is an element that supports and assists movement. It offers a safe setting for regaining strength and joint range of motion.

Faster progress: Aerobic conditioning can often be performed in the water, even when it may be too soon or too difficult to do in the clinic. Staying stable in the water, challenges your core and balance. Plus, sports specific activity can begin earlier than on land.

old man swimming

Who Can Benefit From Aquatic Therapy

• Chronic pain patients requiring a more gentle form of therapy
• Patients at risk of falls due to balance and gait disorders
• Patients with severe arthritis or other weight-bearing restrictions
• Prenatal and postnatal patients
• Patients with general deconditioning
• Sports medicine and orthopedic patients requiring an accelerated component to their rehab protocol

This information was written by Life Fitness Physical Therapy, a privately-owned, outpatient physical therapy practice operating 14 clinics in the metro and surrounding Baltimore, Maryland area. Life Fitness Physical Therapy was founded in 2000 based on the core values of providing the highest level of customer service and clinical excellence in outpatient physical therapy. For more information click here.

physical therapy

Try Physical Therapy First

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Benefits of Physical Therapy Over Pain Killers and Surgery:

  • Conservative treatment with physical therapy has no side effects
  • Treat the cause of the problem and not just the symptoms
  • The best effect is getting you more involved in a healthy lifestyle
  • Affordable and covered under most insurance plans

As Physical Therapists We Provide:

  • Improved awareness
  • Increase strength and flexibility
  • Education and exercise designed to prevent future injuries
  • A program that increases your overall strength and flexibility
  • Modifications of movement for daily living

spine doctor

DID YOU KNOW THAT IF YOU HAVE…

BACK PAIN
If you are experiencing physical pain going to physical or occupational therapy for a musculoskeletal screening first may result in long term solutions without the use of expensive prescriptions or tests such as MRI’s, and reduces the risk of re-injury.
Source: http://www.ncbi.nlm.nih.gov/m/pubmed/22614792/

KNEE INJURY
Physical Therapy is equally effective In treating degenerative knee disease. One of the most common orthopedic procedures in the United States — knee arthroscopic surgery — is proving to be an unnecessary course of action for many patients who have a torn meniscus in their knee.
Source: New England Journal Of Medicine: http://www.nejm.org/doi/full/10.1056/NEJMoa1305189?query=featured_home&

CONCUSSION
Physical Therapists are key to helping in the recovery from concussion by monitoring the physical, mental, and emotional symptoms of an athlete to determine when they are no longer symptomatic.
Source: http://www.momsteam.com/health-safety/post-concussion-treatment-physical-therapy-can-help

We understand that you are concerned with maintaining your health. So ask your medical provider if physical therapy is the right choice for you. By trying physical therapy first, it is likely that you can reduce or remove the need for surgery, as well as remove the risk of dependence on prescription pain killers.

Low back pain

Exercise May Reduce Risk of Low Back Pain

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Low back pain is a common complaint that can last a few days or weeks or become a chronic condition with significant impact on well being. Treatments can vary depending on the cause.Chronic back pain can be difficult to successfully treat and it may take some time to find what treatment works best for each person. Since treatment is not guaranteed to work, prevention is the best option. Back pain is often the result of long term stress on the back such as poor posture, sedentary behavior, or regular strain on the back. Prevention will likely involve a number of different steps to reduce these stresses. However, existing studies have not found clear recommendations for the best methods to go about it.

Researchers wanted to investigate the effectiveness of a number of interventions for the prevention of low back pain. The study, published in JAMA Internal Medicine, found that exercise alone or in combination with education was most effective for preventing low back pain.

About the Study
The systematic review of 21 randomized controlled trials included 30,850 men and women without low back pain. The participants were randomized to 6 different prevention strategies, including exercise, education, exercise plus education, back belt, and shoe insoles. The control groups received no intervention, minimal interventions, or placebo.

When compared to the control group exercise was associated with:
• Fewer low back pain episodes in the first 12 months (in 4 trials with 898 people)
• Fewer sick days due to back pain in follow up 12 months or longer (in 2 trials with 128 people)
• Reduction in short-term (4 trials with 422 people) and long-term low-back pain episodes (2 trials with 138 people) when combined with education

Education alone, back belts, and shoe insoles did not appear to have any benefit during the trials.

man stretching

How Does This Affect You?
A systematic review combines the results of several smaller studies to arrive at one result. The benefit of this type of review is that it increases the number of participants which increase reliability of results. However the review is only as reliable as the studies that are included and the method used to combine the results. There were some flaws in every trial that were included in this analysis. For example, many of the included trials had a high dropout rate during the trial which decreases the reliability of their results.

Low back pain is often associated with an imbalance or weakness of certain back muscles. An exercise program will improve your physical fitness, strengthen your back muscles, and help you maintain a healthy weight. Regular physical activity may also help maintain a healthy weight which can also put strain on your back. Choose exercises or activities that you enjoy and will make a regular part of your day. For most people, this could include 30 minutes of moderate aerobic exercise per day.

Check with your doctor before starting any exercise program.

by Cynthia M. Johnson, MA

RESOURCES:
Family Doctor—American Academy of Family Physicians
http://familydoctor.org

Ortho Info—American Academy of Orthopaedics
http://orthoinfo.aaos.org

SOURCES:
Acute low back pain. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated March 2, 2016. Accessed March 22, 2016.

Steffens D, Maher CG, et al. Prevention of low back pain: a systematic review and meta-analysis. JAMA Intern Med. 2016 Feb 1;176(2):199-208.

Last reviewed April 2016 by Michael Woods, MD

EBSCO Information Services is fully accredited by URAC. URAC is an independent, nonprofit health care accrediting organization dedicated to promoting health care quality through accreditation, certification and commendation.