Brisk Walks May Help, Not Harm, Arthritic Knees

Brisk Walks May Help, Not Harm, Arthritic Knees

If you suffer from knee arthritis and worry that walking will only worsen your damaged joint, a new study suggests you put your fears aside, slip on some sneakers, and take a brief but brisk walk.

The researchers estimated that if older adults with the condition added just 5 minutes of brisk walking to their day, their odds of needing knee replacement surgery could dip by 16 percent.

On the other hand, light walking — akin to a “stroll” — may have no impact, said lead researcher Hiral Master, a Ph.D. candidate in biomechanics and movement sciences at the University of Delaware.

Her team reached those conclusions by digging into data from over 1,800 older adults with knee arthritis who wore portable devices that tracked their walking intensities for at least four days.

Over the next five years, 6 percent of the participants had total knee replacement surgery.

The researchers used the data on people’s walking habits to examine the effects of replacing “non-walking” time with time spent walking at different intensities. The findings showed that substituting just 5 minutes of down time with moderate-to-high intensity walking was linked to a 16 percent decline in the odds of needing knee replacement surgery.

The study authors defined “moderate-to-high” intensity as more than 100 steps per minute. In laymen’s terms, Master said, that’s a “brisk” walk that gets your heart rate up — not a stroll around the block.

The findings were presented Saturday at the American College of Rheumatology’s annual meeting, in Chicago. Such research should be considered preliminary until published in a peer-reviewed journal.

Knee osteoarthritis develops when the cartilage cushioning the joint gradually breaks down, which can eventually result in bone scraping on bone.

The condition is common among middle-aged and older Americans. According to the Arthritis Foundation, up to 13.5 percent of men and 19 percent of women aged 45 and older have knee arthritis that’s severe enough to cause pain and other symptoms.

And those patients often wonder whether walking is good or bad for their arthritic joints, said Dr. Paul Sufka, a rheumatologist at the University of Minnesota, in Minneapolis.

“They often ask whether they should minimize their activity, keep doing what they’re doing, or intensify,” said Sufka, who is also with the American College of Rheumatology’s communications committee.

“The general advice we give to patients is to stay active,” Sufka said. But, he added, the truth is there is too little evidence to give patients definitive recommendations.

The new findings do not prove that brisk walking directly lowers the risk of needing knee replacement surgery, Sufka noted.

But, “this gives us some useful information to bring to the discussion,” he added.

Overall, Sufka said, research does suggest it’s better for people with knee arthritis to be active rather than sedentary. And that’s not just for the sake of their knees. Physical activity has a range of health benefits, including lower risks of heart attack and stroke.

Master agreed, and pointed out that exercise can help arthritis patients’ mental well-being, as well as physical.

And it doesn’t take a huge lifestyle change, she explained. The new findings suggest people can benefit from adding a short, brisk walk to their day.

In fact, Sufka said, such incremental shifts may be best.

“The best exercise program is the one you can actually stick with,” he said. “If right now, you’re walking around the block every day, what would be 5 percent or 10 percent more than that? You can gradually build from where you are.”

And what if walking is painful? That’s a tricky question, Sufka acknowledged. Some patients might benefit from physical therapy rather than only exercising on their own, he said.

Beyond aerobic exercise like walking, strengthening exercises for the leg muscles supporting the knees can also be helpful, he suggested.

More information

The Arthritis Foundation has an overview on knee arthritis.

SOURCES: Hiral Master, P.T., M.P.H., Ph.D. candidate, biomechanics and movement sciences, University of Delaware, Newark, Del.; Paul Sufka, M.D., assistant residency director, internal medicine residency program, University of Minnesota, Minneapolis, and member, communications and marketing committee, American College of Rheumatology; Oct. 20, 2018 presentation, American College of Rheumatology annual meeting, Chicago

Vitamin D Supplements Won’t Build Bone Health in Older Adults: Study

Vitamin D Supplements Won’t Build Bone Health in Older Adults: Study

THURSDAY, Oct. 4, 2018 (HealthDay News) — Vitamin D supplements have long been touted as a way to improve bone health and possibly ward off the bone-thinning disease osteoporosis in older adults.

But a new study contends that claims of benefits from supplements of the “sunshine vitamin” fall flat.

A review of previously published studies found that taking either high or low doses of vitamin D supplements didn’t prevent fractures or falls, or improve bone density.

Vitamin D is found in very few foods. One of the biggest sources of the vitamin is exposure to sunlight.

“Vitamin D supplement use is common, particularly in North America,” where up to 40 percent of older people take them, said lead researcher Dr. Alison Avenell. She is clinical chair in health services research at the University of Aberdeen in Scotland.

“Most adults don’t need to take vitamin D supplements, although they are unlikely to do harm if taken in low doses,” she added.

Vitamin D supplements do prevent rare conditions, such as rickets in children and osteomalacia (softening of bones) in adults. People at risk of vitamin D deficiency include those with little or no sun exposure, such as nursing home residents who are indoors all the time, or those who always cover their skin when outside, Avenell said.

There’s also existing evidence that vitamin D helps prevent cancer or heart disease, she added.

“Preserving bone strength involves keeping active, not smoking, not being too thin, and taking medications for osteoporosis,” Avenell said.

Based on the new findings, Avenell thinks guidelines that recommend vitamin D supplements for bone health should be changed.

For the new report, Avenell and her colleagues reviewed 81 studies, most of which dealt with vitamin D alone, not in combination with the mineral calcium.

“Calcium supplements on their own have minimal effect on bone mineral density and fracture, and may increase the risk of cardiovascular disease,” Avenell said.

The only evidence that calcium and vitamin D together prevent fractures comes from a trial of older people with very low vitamin D levels in nursing homes. But calcium and vitamin D may also increase the risk of cardiovascular disease, Avenell said.

In addition, most of the studies covered in the new review included women aged 65 and older who took more than 800 IUs (international units) of vitamin D daily.

The new study found no meaningful effect of vitamin D supplementation when it came to reducing any fracture, hip fractures or falls.

This type of study, called a meta-analysis, tries to find common elements among previously published studies. This kind or research, however, is limited by differences in the methods and conclusions of the different studies analyzed by researchers, so the findings may not be consistent across the board.

Dr. Minisha Sood, an endocrinologist at Lenox Hill Hospital in New York City, said this new study should convince doctors that vitamin D supplements don’t have a role in maintaining healthy bones, but they do have other benefits.

Previous research suggests that vitamin D, when taken in tandem with calcium, may help prevent certain cancers and protect against age-related declines in thinking and memory.

“What is important to keep in mind is that those with low vitamin D were not represented in this meta-analysis, and vitamin D supplementation — repletion, actually — is still necessary for those with low vitamin D levels, regardless of age,” Sood said.

The findings were published online Oct. 4 in The Lancet Diabetes and Endocrinology.

More information

For more on vitamin D, visit the U.S. National Institutes of Health.

SOURCES: Alison Avenell, M.D., clinical chair, health services research, University of Aberdeen, Scotland; Minisha Sood, M.D., endocrinologist, Lenox Hill Hospital, New York City; Oct. 4, 2018, The Lancet Diabetes and Endocrinology, online

Health Tip: Change Poor Posture

Health Tip: Change Poor Posture

Health Tip: Change Poor Posture

(HealthDay News) — Everyone has back pain at some point, whether due to poor posture, heavy lifting, a spinal condition present a birth, or an exercise-related injury.

While other triggers for back pain may not be as easy to prevent, poor posture is a relatively easy fix.

Harvard Medical School suggests how:

  • By imagining good posture, you can help create it. Imagine a straight line passing through your body from ceiling to floor (the ears, shoulders, hips, knees, and ankles line up vertically).
  • Sit up straight with hands resting on your thighs. Keep your shoulders down and your chin level. Slowly draw your shoulders back and squeeze your shoulder blades together. Hold for a count of five; relax. Repeat three or four times.
  • Stand facing a corner with your arms raised, hands flat against the walls, elbows at shoulder height. Place one foot ahead of the other. Bending your forward knee, exhale as you lean your body toward the corner. Keep your back straight and your chest and head up. Hold this position for about 30 seconds. Relax.
  • Raise your right arm to shoulder level in front of you and bend the arm at the elbow, keeping the forearm parallel to the floor. Grasp the right elbow with your left hand and gently pull it across your chest so you feel a stretch in the upper arm and shoulder on the right side. Hold for 20 seconds; relax both arms. Repeat three times on each side.
Copyright ©2017 HealthDay. All rights reserved.
Physical Therapy for Shoulder Pain

Physical Therapy for Shoulder Pain

Shoulder pain is a common symptom for athletes and office workers alike. These simple exercises can improve flexibility and prevent future injury.

The shoulder’s complex structure makes it susceptible to injury, especially from one-too-many many weightlifting exercises. Whatever the cause of your pain or discomfort, the healing process often involves physical therapy to stretch and strengthen the surrounding muscles.

Be sure to consult a doctor before beginning a physical therapy regimen, as shoulder pain can be a symptom of a variety of conditions, like impingement or a rotator cuff tear. The following exercises offer gentle stretching and light conditioning to get you on the road to recovery.

1. PENDULUM EXERCISE
The pendulum exercise can help you recover from a shoulder injury, as it encourages blood flow and develops your range of motion. To get started, stand near a table with your feet slightly more than shoulder width apart. Place the hand of your uninjured arm on the table, then bend over and let your injured arm dangle toward the floor. Shift your body weight in order to create movement in the arm: forward and back, side to side, or in a small circle. Do not engage your shoulder muscles, but let the arm swing freely.

Start with 30 seconds of motion, a few times per day. Over the next few weeks you can gradually increase to several minutes of movement. You can also do a variation of this exercise on a bed if leaning over is hard on your back or neck, though you may need someone else to set your arm in motion. As your recovery progresses, you may be able to use light dumbbells to further stretch the shoulder — but be careful not to engage the muscles and risk re-injury.

2. SCAPTIONS
This exercise targets the rotator cuff, building strength in the scapula and rhomboids to prevent and relieve pain. It can also help strengthen your back and improve your posture.

Stand with your feet below your shoulders, core engaged and knees at a slight angle. With a light dumbbell in each hand, palms inward, raise your arms out in front of you in a broad V shape. Then slowly draw your shoulder blades together. Be careful not to raise your arms above your shoulders. Hold this position momentarily, then lower. Repeat about ten times, for three sets.

3. EXTERNAL AND INTERNAL SHOULDER ROTATION
The rotator cuff muscles that allow for internal rotation are the supraspinatus and subscapularis. These let you draw your arm forward, with your palm facing in, and are commonly used in gym exercises and everyday life. Overuse causes these muscles to tighten, often leading to pain.

To begin strengthening the rotator cuff, you can practice a simple towel stretch. Grasp a towel or strap with your right hand and drape it over your right shoulder so it hangs down your back. Your right hand should be level with the back of your head, or lower toward the back of your neck if it’s comfortable. Turn your left arm behind your lower back with your palm facing behind you as you raise your left hand to meet and grasp the bottom end of the towel. Don’t force the stretch, but spend 15 to 30 seconds just at your point of flexibility. Try three repetitions on each side, and over time you will be able to bring your hands closer together at your back.

The external rotator muscles in the rotator cuff are the infraspinatus and teres minor. These typically get less training, which can create an imbalance and eventually lead to pain. To strengthen these muscles, use only one- or two-pound weights until you are able to easily add more, one pound at a time. Lie on your side, with your upper arm at a 90-degree angle, elbow against your side. Slowly rotate your forearm out and up, to your side, drawing your shoulder blades together until your palm faces forward. Hold for two seconds, then lower down. Repeat 10 times on each side.

4. SHOULDER RETRACTIONS
There are a number of exercises that involve shoulder retraction, and they all aim to correct a slumped posture. If your shoulder blades, or scapulae, are constantly hunched forward, it can affect how you use your shoulder joint, lift your arms, and stand. Poor posture can even affect the blood flow and nerves in your arms and hands, and make it harder to breathe by collapsing your chest. You should perform shoulder retraction stretches as much as possible to counteract these effects, and build up the muscles to help prevent shoulder pain.

To begin this exercise, stand straight, arms at your sides, with your shoulders relaxed. Pull your shoulder blades down and back, without arching your back. Hold this for 5-10 breaths, and repeat 3-5 times.

For a more targeted exercise, lie facedown on a mat, resting your forehead on a towel. Hold your arms straight out at your sides, palms down. Use your shoulder blades to lift your arms off the floor, holding this position for a few breaths.

EXERCISES TO AVOID
As you perform these exercises, keep in mind that shoulder pain can have many underlying causes, and without a doctor’s diagnosis you risk exacerbating the issue. Take your time when introducing new exercises into your routine to give your body time to adjust. To avoid further damage, be sure to start with no weight or very light weights for any strengthening activities.

You should also avoid exercises that are counterproductive to the healing process. Stay away from common gym exercises like dips, upright rows, overhead presses, and lat pull downs done behind the neck, which can put stress on the neck and shoulders.

If you’re suffering from shoulder pain, you may want to schedule an appointment with an orthopedic specialist. At CompOrtho, specialists will help identify any underlying conditions that may be causing you discomfort.

Low Back Pain? These Exercises May Help

Low Back Pain? These Exercises May Help

THURSDAY, Aug. 30, 2018 (HealthDay News) — Low back pain is a common health complaint. And if it sidelines you for too long, it can lead to weight gain, a loss in your fitness level and keep you from doing things you love.

But not moving isn’t the answer — specific exercises can help you get back to everyday activities. If you’re under the care of an orthopedist or physical therapist, you may be given a series of exercises to do up to three times a day.

Here are three in particular that may help.

Tummy contractions. Lie on your back with your knees bent, feet flat on the floor hip-width apart, and your hands on your tummy below your ribcage. Tighten your abs — it should feel as though your ribcage is being pressed toward your back. Hold for five seconds, then relax. Repeat 10 times.

Knee-to-chest stretch. Begin in the same starting position, but for this exercise, place both hands on the back of your left thigh and gently pull the knee to your chest. Hold for 20 seconds, then relax. Repeat five times with the left leg, then switch to the right leg and repeat the entire sequence.

Body stretch sequence. Sit on a large exercise ball with knees bent at a 90-degree angle to the floor. Move your feet slightly out to the sides for balance. First, lift your left arm straight up over your head, then lower it and repeat with the right arm; alternate five times. Next, slowly raise and lower your left heel, then slowly raise and lower your right heel; alternate five times. Finally, raise your left arm overhead and your right heel off the floor at the same time, lower them and reverse, raising your right arm overhead and lifting your left heel off the floor; alternate five times.

Another type of exercise that may help is yoga. According to a study published in the Annals of Internal Medicine, people who took a weekly class designed for those with low back pain were helped just as much as those who did traditional physical therapy, and needed less pain medication over time.

More information

The University of California, Berkeley, has detailed information on low back pain and more exercises that can help ease it.

Copyright ©2017 HealthDay. All rights reserved.
Health Tip: Prevent Back Pain at Work

Health Tip: Prevent Back Pain at Work

(HealthDay News) — Chronic back pain makes it more difficult to do your job, whether you’re behind a desk or operating heavy machinery.

The Mayo Clinic suggests how to avoid back pain at work:

  • Maintain good posture.
  • Lift with your legs and tighten your core muscles, and avoid twisting.
  • When possible, use a lifting device.
  • Alternate physically demanding tasks with less demanding ones.
  • Limit the time you spend carrying heavy briefcases, purses or bags.
  • Listen to your body. Change your position often and periodically walk around and stretch your muscles.
Copyright ©2017 HealthDay. All rights reserved.