Everyone should strengthen their ankles!

Everyone should strengthen their ankles!

Injuries of the ankle are common among athletes and amateurs in many different sports and exercises. Working out at the gym, enjoying summer jogs, or playing any type of sport are typical ways to injure your ankle. Unfortunately, spraining, rolling, or fracturing your ankle is easy to do and will often occur again without the proper rehabilitation and strengthening of your ankle joint. Strengthening your ankles is also a great way to do thing outside of sports – such as wear high heeled shoes without wobbling!

There are many exercises and stretches you can do to strengthen your ankles, which can help to prevent future injury or help to recover from a previous ankle injury.

Balance Training

Working on your balance strengthens your ankles, as they are the joints that hold your weight steady on your feet. Try holding your weight on one foot, grabbing your opposite ankle behind your back. Work toward increasing the amount of time you balance on each foot. Eventually, work up to catching and throwing a ball while standing on one foot, or doing one-legged squats.

Band Exercises

You can purchase the resistance bands you would find at your physical therapy gym for very little cost. Wrap them around the top of one foot and curl your toes to stretch your foot and ankle. Make sure to match the number of repetitions on the other foot. These bands can be used to stretch the foot and ankle is a variety of ways and directions – consult your physical therapist for proper form and technique.

Jumps and Skips

Another way to strengthen your ankles is to do exercises that require jumping or skipping. These work the muscles in your foot and your ankle. They get your ankles used to landing and absorbing that impact, as well as aiding your balance.

You can do jumping squats, scissors kicks, or do skips or bounds if you are exercising in a large area.

Obesity to Blame for Epidemic of Knee Dislocations, Complications

Obesity to Blame for Epidemic of Knee Dislocations, Complications

Need another reason to keep your weight under control?

Excess weight can cause dislocation of your knee and may even lead to a complication that results in amputation of your leg.

A new study attributes a surge in dislocated knees to the U.S. obesity epidemic.

“Obesity greatly increases the complications and costs of care,” said study lead author Dr. Joey Johnson, an orthopedic trauma fellow at Brown University’s Warren Alpert Medical School.

“As the rate of obesity increases, the rate of knee dislocations increases. The total number of patients who are obese is increasing, so we are seeing more of these problems,” Johnson explained.

Knee dislocations result from multiple torn ligaments. Vehicle crashes or contact sports, such as football, are common causes.

For the study, the researchers analyzed more than 19,000 knee dislocations nationwide between 2000 and 2012. Over that time, people who were obese or severely obese represented a growing share of knee dislocation patients — 19 percent in 2012, up from 8 percent in 2000.

Obesity is also linked to more severe knee dislocations, longer hospital stays and higher treatment costs, according to the study published recently in the Journal of Orthopaedic Trauma.

And the chances that a knee dislocation would also injure the main artery behind the joint and down the leg were twice as high for obese patients than for those whose weight was normal, the findings showed. This severe complication of knee dislocation — known as a vascular injury — can lead to leg amputation if not treated, the study authors said.

Patients with a vascular injury averaged 15 days in the hospital, compared with about one week for other patients. Their average hospitalization costs were just over $131,000 and $60,000, respectively.

The study authors said doctors should be especially watchful for vascular injury in obese patients whose knees are dislocated.

“That subset of obese patients who come in with complaint of knee pain need to be carefully evaluated so as not to miss a potentially catastrophic vascular injury,” said study co-author Dr. Christopher Born, a professor of orthopedics at Brown.

Reducing obesity rates could help reverse the growing number of knee dislocations, the researchers suggested.

More information

The U.S. National Institute of Arthritis and Musculoskeletal and Skin Diseases has more on knee problems.

SOURCE: Brown University, news release, Nov. 3, 2017

Don’t Delay Hip Fracture Surgery. Here’s Why

Don’t Delay Hip Fracture Surgery. Here’s Why

Seniors with a fractured hip need surgery as soon as possible or they could suffer life-threatening complications, a new Canadian study concludes.

Having surgery within 24 hours decreases the risk of hip fracture-related death. It also lowers odds of problems such as pneumonia, heart attack and blocked arteries, the researchers found.

“We found that there appears to be a safe window, within the first 24 hours,” said lead researcher Daniel Pincus, a doctoral student with the University of Toronto.

“After 24 hours, risk began to clearly increase,” Pincus said.

U.S. and Canadian guidelines recommend hip fracture surgery within 48 hours of injury, but it’s likely that many people don’t receive care that quickly, he noted.

In the United Kingdom, guidelines call for surgery within 36 hours, but hospitals often fail to get patients promptly into the operating room, Pincus added. Rates range from 15 percent to 95 percent among U.K. hospitals, according to the report.

Oftentimes, there’s no operating room or surgeon available, or other patients are awaiting surgery, Pincus explained.

“There’s a triage system and these patients historically were not prioritized,” he said. “Sometimes there’s medical reason for the delay, but that’s very rare. We’re starting to realize there’s almost no reason why a patient should be delayed.”

Delay also likely occurs because doctors approach these elderly patients with a good deal of caution, said Dr. Harry Sax. He is executive vice chair of surgery for Cedars-Sinai Medical Center in Los Angeles.

“The perception is that if you’re old and you’ve broken your hip, that you’re going to have a lot of other [health problems],” said Sax, co-author of an editorial accompanying the new study. “Therefore, I need to spend several days running tests on you to try to make sure I can get you through the hip fracture surgery. ”

To see how this delay affects the health of patients, Pincus and his colleagues evaluated data on over 42,000 people treated for hip fracture at 72 hospitals in Ontario between April 2009 and March 2014. The patients’ average age was 80.

The investigators compared patients based on whether they had surgery before or after 24 hours.

Overall, about 12 percent of hip fracture patients died within the month following their surgery.

However, patients who got surgery within 24 hours were 21 percent less likely to die during the following month, compared with those who had a delay in surgery, the findings showed.

Those patients also had lower complication rates. They were 82 percent less likely to develop a blood clot in the leg veins (deep vein thrombosis); 61 percent less likely to have a heart attack; and 49 percent less likely to suffer a blood clot in the lung (pulmonary embolism). They were also 5 percent less likely to develop pneumonia during the month following surgery.

“The problem is the longer you sit in bed, the more likely you are to get pneumonia and blood clots. The unfixed bone is continuing to flick off little bits of fat, which can go to the lungs,” Sax said. “The delay doesn’t necessarily make things better. It could make things worse.”

People with an elderly relative facing hip fracture surgery should ask the health care team to get their loved one into surgery as soon as possible, with as little additional testing as possible, Pincus and Sax said.

“A prompt evaluation to make sure there’s nothing quickly correctable should be done, but otherwise the patient should move to the operating room as quickly as possible,” Sax said.

Families should ask doctors about every test, scan or screen that delays the surgery, Sax said.

“The question needs to be, what is the information that you’re going to gain and how would that change your management of this patient,” Sax said. “There are very few things you find with all this expensive testing that you can do anything about.”

The patient would be best off in a hospital that has a specific program to manage elderly people with hip fractures, Sax added. These programs have a team of surgeons, geriatricians, anesthesiologists and other professionals well-versed in the procedure.

“If you can find a hospital that does that, the chances are your outcomes are going to be better,” Sax said.

The study was published Nov. 28 in the Journal of the American Medical Association.

More information

For more on hip fractures, visit the American Academy of Orthopaedic Surgeons.

SOURCES: Daniel Pincus, doctoral student, University of Toronto, Ontario, Canada; Harry Sax, M.D., executive vice chair, surgery, Cedars-Sinai Medical Center, Los Angeles; Nov. 28, 2017, Journal of the American Medical Association

This Weight-Loss Strategy May Not Help Your Knees

This Weight-Loss Strategy May Not Help Your Knees

Weight loss from dieting can slow the progression of knee arthritis in overweight people, according to a new study.

But losing pounds from exercise alone will not help preserve those aging knees, the researchers found.

Obesity is a major risk factor for painful knee osteoarthritis — degeneration of cartilage caused by wear and tear. Weight loss can slow the disease, but it wasn’t clear until now if the method of weight loss made a difference.

Apparently, it does.

“These results add to the hypothesis that solely exercise as a regimen in order to lose weight in overweight and obese adults may not be as beneficial to the knee joint as weight loss regimens involving diet,” said lead author Dr. Alexandra Gersing.

Gersing made her comments in a news release from the Radiological Society of North America (RSNA). She’s with the University of California, San Francisco’s department of radiology and biomedical imaging.

The study included 760 overweight or obese adults who had mild to moderate knee osteoarthritis or were at risk for it. The participants were divided into a “control group” of patients who lost no weight, and a group who lost weight through either a combination of diet and exercise, diet alone, or exercise alone.

After eight years, cartilage degeneration was much lower in the weight-loss group than in the control group. However, that was true only of people who lost weight through diet and exercise, or diet alone, the investigators found.

Study participants who exercised without changing their diet lost as much weight as those who slimmed down through diet plus exercise or diet alone, but there was no significant difference in cartilage degeneration compared to the control group.

The study was scheduled for presentation Tuesday at the annual meeting of the RSNA, in Chicago. Research presented at medical meetings should be considered preliminary until published in a peer-reviewed medical journal.

More information

The American Academy of Orthopaedic Surgeons has more on knee arthritis.

SOURCE: Radiological Society of North America, news release, Nov. 28, 2017

Smoking Linked to Frailty in Seniors

Smoking Linked to Frailty in Seniors

Seniors who smoke may be more likely to become frail, a new British study suggests.

Researchers tracked more than 2,500 people 60 and older in England and found that current smoking boosted that risk by about 60 percent. The scientists determined that the participants were frail if they had at least three of five conditions: unintentional weight loss, self-reported exhaustion, weakness, slow walking speed, and low physical activity.

Frail people are at higher risk of problems such as falls, broken bones and hospitalization. Researchers have also linked frailty to poor quality of life and dementia.

Interestingly, the researchers found that former smokers didn’t face a higher risk of frailty, and it didn’t matter if they’d quit within the past 10 years or earlier. In fact, their risks of frailty were about the same as those who had never smoked.

The research team also found evidence that chronic obstructive pulmonary disease (COPD), a respiratory condition that is typically brought on by years of smoking, boosts the risk of frailty.

But the study did not prove that smoking caused frailty risk to rise, just that there was an association.

The study was published recently in the journal Age & Ageing.

“Our study showed that current smoking is a risk factor of developing frailty. Additional analyses revealed that COPD seems a main factor on the causal pathway from smoking towards frailty,” study author Dr. Gotaro Kojima said in a journal news release. “But those who quit smoking did not carry over the risk of frailty.”

Kojima is geriatrics specialist from University College London.

More information

For details about how to quit smoking, visit the smokefree.gov.

SOURCE: Oxford University Press, press release, Aug. 17, 2017

How You Think About Your Arthritis Makes a Difference

How You Think About Your Arthritis Makes a Difference

How well you cope with knee arthritis depends a lot on your mental outlook, a new study suggests.

Despite often-debilitating pain, people who remain confident in their ability to move about end up more active than their less confident peers, researchers found. Studies have shown that physical activity may be one of the best ways to reduce and manage symptoms of osteoarthritis.

The Pennsylvania State University study was based on 135 adults with knee arthritis.

“On days when patients felt more confident in their ability to be active, they indeed took more steps and spent more time in moderate-intensity activity, despite their level of pain that day,” said study lead author Ruixue Zhaoyang.

What’s more, “this positive effect of patients’ confidence on their actual physical activity was found for patients with varying degrees of pain in the morning,” added Zhaoyang, a post-doctoral fellow with the university’s Center for Healthy Aging.

The researchers also observed that predicting individual activity levels was best done by focusing on someone’s personal confidence, rather than comparing them to someone else.

“It’s all about what you think you’re able to do,” Zhaoyang said.

The findings “suggest that future physical activity interventions for people with osteoarthritis should target patients’ confidence in their ability to be active,” said Zhaoyang.

But the key, she said, will be to focus on boosting each individual’s confidence patterns, and not on some universal benchmark.

Arthritis is a major cause of chronic pain for many adults. The U.S. Centers for Disease Control and Prevention estimates more than one-third of American seniors have osteoarthritis, the wear-and-tear form of the disease. Symptoms typically include joint pain, swelling and stiffness.

Such patients are often caught in a catch-22 situation. While research has shown that physical activity is effective for pain and overall function, the ongoing pain makes it hard to meet federal recommendations for at least 2.5 hours of moderate-intensity activity a week.

Not exercising leads to greater stiffness and deterioration in muscle strength, the researchers said.

For this study, the investigators wanted to see how someone’s “self-efficacy” in the morning affected their day-to-day living with arthritis. This term refers to the degree to which people feel confident in their capacity to do or achieve something.

The researchers used accelerometers to track each participant’s total number of steps and the physical intensity of their daily activities over roughly three weeks.

Each morning the patients also noted how confident they felt in their ability to keep active, their pain level, and their overall mood.

The research team found that those who felt more confident in the morning about their ability to get around did actually move more throughout the day. This was so despite shifting levels of pain, mood or support from a spouse.

The study was published recently in the journal Health Psychology.