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

5 Physical Therapy Exercises for Neck Pain

5 Physical Therapy Exercises for Neck Pain

Non-invasive treatments should be your first line of defense against neck pain.

Workouts, sports, and even sitting at a desk all day can put strain on the neck, leading to pain and discomfort. While some conditions may require orthopedic surgery, non-invasive treatments often lead to better long-term outcomes, and should generally be the first line of defense against neck pain.

A qualified physical therapist can help you create an appropriate plan for chronic neck pain, which is defined as pain that lasts for more than a few weeks. With a physical therapy plan tailored to your needs, you can safely gain strength and flexibility, as well as lower your chance of developing a future neck injury.

If you’re suffering from neck pain and looking to find relief, your physical therapist might suggest some of the following exercises.

1. SHOULDER AND HEAD ROLLS

These stretches are a good warm-up to start with before attempting other exercises. For a shoulder roll, keep your arms relaxed at your sides, and with your head upright, simply lift and roll your shoulders. Relax briefly between each roll. Do ten rolls forward, and ten back.

Before you try a head roll, stretch the neck. Make sure your shoulder blades are relaxed, and that your head is not tilted forward but sits directly over your neck. Start by dipping your chin slowly toward your chest, and hold for several breaths (if you are unable to dip your chin, or if it causes an increase in pain, stop and contact your doctor). Next, lift your head and lower your left ear toward your left shoulder, and hold. Repeat this movement on the right side, then do a similar stretch with your head tilted back.

After stretching your neck, you can roll your head slowly in sections, from tucked in front or tilted back toward each side, five times each. Avoid doing a full head roll, which can actually strain the neck.

2. SEATED NECK STRETCH

Deceptively simple, this exercise can even be performed at your desk. For a seated stretch, sit upright in your chair with your feet flat on the ground. Extend your right arm along your right side and place your left hand on the top of your head. Tilt your head to the left, applying pressure with your hand to gently intensify the stretch. Hold for 30 seconds, then repeat for the right side. You will feel this stretch in the levator scapula muscles in the sides of the neck.

3. WALL PUSH-UP

This exercise can help strengthen your shoulders and support your neck muscles, without causing as much stress as typical push-ups. Stand facing a wall, with two to three feet of space in front of you and your feet shoulder-width apart. Place your hands against the wall, just below shoulder level. Start with straight arms, and bend your elbows slowly to bring your body closer to the wall. Repeat this 10 times for one or two sets.

4. AQUATIC EXERCISES

While high-impact sports can be hard on the neck, low-impact sports like swimming, walking, or recumbent biking may help you avoid strain. If you have neck pain, many physical therapists recommend that you hit the pool for your aerobic exercises in order to increase blood flow to the neck.

While in the water, you can attempt neck flexibility stretches like the “clock” exercise. Repeat the following on both sides:

  • Stand in a lunge position, with both arms at shoulder height. While the right foot and hand are forward at a 12 o’clock position, sweep the left hand back to 6 o’clock, following with the head and body. Repeat five times.
  • Keep the left hand sweeping to 6 o’clock, while the head moves only to 9 o’clock, for five repetitions.
  • For the last set of five, the head remains at 12 o’clock while the arm sweeps to 6 o’clock.

5. PRONE ROWS

This exercise strengthens the muscles that pull the shoulder blades together. You’ll want to lie facedown on a bed or similar surface, angled so that your face is in a corner, and you can dangle your arms off each side. Row upward, bending the elbows and squeezing the shoulder blades together without moving your head. Try about 20 repetitions for one or two sets. You can add light weights to this exercise if it is too easy.

EXERCISES TO AVOID

While adding these exercises to your routine, you should be careful to avoid workouts that may impede your progress. Don’t do sit-ups or crunches, as these can strain your neck vertebrae. In weightlifting, both the military press and lat pulldown put pressure on the vertebrae, and should be avoided.

The five exercises above can get you started on the road to recovery, although for best results, we recommend working with a physical therapist. If these exercises don’t relieve your pain, or cause pain that shoots into your shoulders or arms, contact a doctor as soon as possible. The orthopedic specialists at Comprehensive Orthopaedics can help you develop a personalized treatment plan and get back to the activities you love.

Low-Impact Yoga, Pilates Brings Big Health Benefits at All Ages

Low-Impact Yoga, Pilates Brings Big Health Benefits at All Ages

Yoga and Pilates are suitable for people of all ages and fitness levels, medical experts say.

These low-impact workouts don’t require special equipment and, after initial training, can be done at home to improve physical and mental health.

“Both use your own body weight and can be tailored for levels from beginner to advanced,” said Dr. Jayson Loeffert. He’s a primary care sports medicine physician at Penn State Health Milton S. Hershey Medical Center.

Pilates aims to strengthen core muscles between the shoulders and pelvis, while yoga tends to focus on the mind-body connection, and often includes meditation and breathing techniques. Yoga can help people manage stress, according to the American Osteopathic Association.

Both exercises include slow, careful movements that can improve strength, balance and flexibility. Beginners should attend classes to learn how to do these exercises correctly, Loeffert advised.

Because they are low impact, yoga and Pilates are ideal for people with arthritis or injuries. “Most people can tolerate it without much problem,” Loeffert said. “It’s good for healing.”

The exercises also help people with diabetes, high blood pressure or neuropathy (problems with nerves) in their legs, he said.

Yoga and Pilates have other benefits, too, according to nurse practitioner Barbara Cole, who is also at Penn State Health. Among them: preventing and treating back pain; boosting posture and balance; increasing range of motion; and improving sleep.

Pregnant women and people with high blood pressure, risk of blood clots, herniated disks or other pre-existing conditions should check with their doctor before beginning yoga or Pilates, Cole recommended.

5 Easy Adjustments to Avoid Back Injuries During Weightlifting

5 Easy Adjustments to Avoid Back Injuries During Weightlifting

Back injuries often plague those who lift weights on a regular basis — but with some proactive adjustments to your routine, you can significantly decrease your risk.

From rows to squats, the back plays a critical role in many weightlifting exercises — and developing strong back muscles can help you push yourself farther at the gym for a wide variety of lifts.

As with any part of your body, it’s impossible to keep your back completely safe from injury while you’re working out, but there are some simple steps you can take to significantly decrease your risk. When the price of a setback is not only losing hard-won progress, but potentially developing more serious health issues, prevention is well worth the effort.

With all of that in mind, here are five tips to prevent common back injuries while you lift.

1. TRAIN YOUR POSTURE

As you probably know, poor form greatly increases your risk of injury in any exercise. If you’re working on your back, you’ll want to keep your vertebrae neatly aligned to avoid placing too much pressure on a particular bone or muscle.

If you’re new to lifting, don’t simply mimic what you see others doing at the gym. Instead, ask a trainer or do some research online in order to better understand how you should position your body. If you’re a more experienced gym-goer, it’s still a good idea to check up on your form every now and then. Protect your body by regularly recalibrating your form and squelching any bad habits before they lead to injury.

2. RECOGNIZE THE RISKS

Any weightlifting exercise that involves flexion (forward bending) or extension (backward bending) of the joints in your back puts those areas at risk. These movements often result in sprains (a tear or rupture of a ligament), but they can lead to more serious injuries as well. Extreme extension, for example, can lead to spondylolysis, or cracks in the vertebrae. Similarly, extreme flexion can lead to a herniated disc.

These risks aren’t limited to exercises that specifically target the back. The most common weightlifting-related cause of herniated discs is the deadlift, which — when done properly — doesn’t depend on back flexion or extension for power, but when done incorrectly, puts a dangerous amount of pressure on the vertebrae. Deadlifts can also exacerbate degenerative disc disease, lumbar spinal stenosis, and other chronic conditions affecting the lower back.

3. KNOW WHEN IT’S TIME TO STOP

That twinge you felt while working out might be gone by tomorrow with a bit of stretching and rest. If you push the compromised area through additional stress, however, it can turn into something worse.  Don’t ignore what your body is telling you. The burn of a fatigued muscle feels very different from a pull in your back, and “no pain, no gain” only works when you don’t sabotage the body you’re trying to strengthen. If you’re feeling pain when lifting, it’s time to call it a day — plain and simple.

4. MODIFY YOUR ROUTINE

First off, I recommend that you always wear a weightlifting belt when working out, as it can do wonders to stabilize and protect your back during most exercises. However, if a particular movement causes you problems even with the belt on, consider finding an alternative. For most lifts, there are one or more corresponding exercises that can target similar muscles without causing the same pain.

5. STRETCH

To learn proper posture is one thing, but to fully put it into practice requires some extra work. As any knowledgeable trainer will tell you, a dedicated stretching routine is the key to sustainable lifting. In order to build a strong and resilient back, consult a fitness trainer or orthopedic specialist you trust and create a stretching regimen to maintain the integrity of your back for future challenges. For maximum benefit, stretch both before and after each lifting session.

Exercises for Chronic Health Conditions

Exercises for Chronic Health Conditions

Exercise can help prevent many chronic illnesses as well as make it easier to manage health conditions, from diabetes to joint pain.

In terms of prevention, aim for the recommended 150 minutes of exercise, like brisk walking or cycling, each week. Along with eating a healthy diet, this can cut your risk of diabetes by more than a third, plus increase your level of good cholesterol. Exercise also lowers body weight, blood pressure and triglycerides, thus reducing key risk factors for heart disease.

If you’re already managing a chronic illness, exercise may improve symptoms and reduce the amount of medication you need to take. It builds muscle, which helps you move more easily, and reduces stress, which can aggravate many health conditions. Back pain and arthritis improve with the right stretching and exercise plan. If you have diabetes, exercise can improve blood sugar control.

Exercise’s health effects on:

Heart disease: Regular aerobic exercise and interval training in particular are heart-healthy, boosting cardiovascular fitness.

Back pain: Core exercises strengthen the muscles around your spine, creating better support for your spine.

Arthritis: Exercise enhances the muscles that support your joints, making movement easier; it also eases stiffness.

Diabetes: Exercise helps you use insulin more effectively and lower your blood sugar level.

Asthma: Exercise can help control attacks.

If you’re managing an illness and haven’t been active, talk to your doctor about what exercises are safe, any precautions to take, what kind of discomfort is normal, and what are signs to stop, like feeling dizzy, short of breath or chest pain.

Working with your doctor is especially important when you have diabetes. Because exercise can affect blood sugar, you’ll need to take precautions to prevent blood sugar from becoming too low during workouts.

In terms of intensity, start off slow — that means you should be able to talk, but not sing, when working out.

More information

The Cleveland Clinic has detailed tips on exercising with a chronic condition to help you get started safely.