Health Tip: Help Prevent Bone Fractures

Health Tip: Help Prevent Bone Fractures

More than 53 million people in the United States have osteoporosis or are at higher risk due to low bone mass, the U.S. National Institutes of Health says.

If you’re at greater risk of osteoporosis, how can you reduce your chances of developing a bone fracture? Here are the agency’s suggestions:

  • Help protect your bones by taking calcium and vitamin D supplements, or by getting enough of these essentials through your diet.
  • Limit salt.
  • Eat enough protein. Women should have 46 grams a day and men should have 56 grams a day.
  • Exercise to build and maintain bone density.
  • Reduce your risk of falling by practicing balance, flexibility and strength exercises.
  • Keep a tidy home, free of clutter that could become a tripping hazard.
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Widely Used COPD Meds Tied to Increased Fracture Risk

Widely Used COPD Meds Tied to Increased Fracture Risk

TUESDAY, Feb. 13, 2018 (HealthDay News) — Many patients with chronic obstructive pulmonary disease (COPD) are placed on powerful inhaled corticosteroid therapy to ease symptoms.

But new research suggests the treatment might raise their odds for bone fractures.

Still, the Canadian study wasn’t able to prove cause-and-effect, and the overall risk remained small, said one expert not connected to the study.

“Looking at their data, there would be an estimated 1 [extra] fracture for every 241 patients using high-dose inhaled corticosteroids for over four years,” said Dr. Walter Chua. He’s the senior attending physician for pulmonary care at Northwell Health’s Long Island Jewish Forest Hills hospital in Forest Hills, N.Y.

Chua believes that although steroids may raise bone fracture risk, “patients should not panic as the risk of fracture is small and we have ways of monitoring that risk.”

COPD — often linked to smoking — is a combination of emphysema and chronic bronchitis. It is a progressive, debilitating illness that currently has no cure. COPD remains the number three killer of Americans.

Many COPD patients are given inhaled corticosteroid medications to help alleviate symptoms. But, according to the study team, prior research has suggested that the drugs may reduce bone mineral density, particularly in postmenopausal women.

The new study was led by Dr. Samy Suissa of McGill University in Montreal. His team tracked outcomes for more than 240,000 COPD patients, aged 55 and older, in the Canadian province of Quebec.

During an average follow-up of just over five years, the overall fracture rate was just over 15 people per 1,000 patients per year.

However, the rate was higher among patients who had used inhaled corticosteroids for longer than four years, at daily doses of 1,000 micrograms or more.

Gender didn’t seem to play a role, since the risk rose equally for men and women, Suissa’s team said.

The study appears in the February issue of the journal Chest.

“Since fractures are more frequent in women than men, our study suggests that the excess number of fractures associated with [inhaled corticosteroids] will be greater in women — even though we did not find that the risk increase was particularly higher in women than in men,” Suissa said in a journal news release.

So what does this mean for the many COPD patients who are using corticosteroids?

Dr. Ann Tilley is a pulmonologist at Lenox Hill Hospital, in New York City. She wasn’t involved in the new research, but read over the findings and stressed that it couldn’t prove cause-and-effect.

Information on other patient factors that might raise bone fracture — things like smoking status, obesity and exercise levels — weren’t accounted for, Tilley noted.

Still, “the most important take-home message here is that long-term use of high-dose inhaled steroids may not be without risk,” Tilley said, “and we should try to minimize their use when possible.”

“I would encourage patients to talk to their doctors about their inhalers and ask specifically if they need to be using an inhaled corticosteroid, and if so, could a lower dose be tried,” she said.

Chua agreed, noting that other research has also shown “a slight uptick in the rates of pneumonia [for COPD patients] while on inhaled corticosteroids.”

He believes that for patients with confirmed COPD, “inhalers containing corticosteroids should generally be reserved as a last line of treatment after optimization of other inhaler alternatives.”

And if patients must use steroids, they “should be monitored for bone mineral density and fracture risk, for which we have medications/therapies to help reduce that risk,” Chua said.

More information

The U.S. National Heart, Lung, and Blood Institute has more on COPD.

SOURCES: Walter Chua, MD , senior pulmonary attending physician, Northwell Health’s Long Island Jewish Forest Hills, Forest Hills, NY; Ann Tilley, MD, pulmonologist, Lenox Hill Hospital, New York City; Chest, news release, Feb. 5, 2018

Preventing Sports Injuries

Preventing Sports Injuries

Exercise is good for the body and with the proper precautions, sports injuries can often be prevented. The quality of protective equipment – padding, helmets, shoes, mouth guards – have helped to improve the safety in sports. But, you can still be susceptible to injury. Always contact your healthcare provider before starting any type of physical activity, especially vigorous types of exercises or sports.

Causes of sport injuries may include:

  • improper or poor training practices
  • wearing improper sporting gear
  • being in poor health condition
  • improper warm-up or stretching practices before a sporting event or exercise

Common sports injuries include:

  • Sprains and strains
  • Joint injuries (knee)
  • Muscle injuries
  • Dislocations
  • Fractures
  • Achilles tendon injuries
  • Pain along the shin bone

How can I prevent a sports injury?

The following are some basic steps to prevent a sports injury:

  • Develop a fitness plan that includes cardiovascular exercise, strength training, and flexibility.  This will help decrease your chance of injury
  • Alternate exercising different muscle groups and exercise every other day.
  • Cool down properly after exercise or sports. It should take 2 times as long as your warm ups.
  • Stay hydrated. Drink water to prevent dehydration, heat exhaustion, and heat stroke.
  • Stretching exercises can improve the ability of muscles to contract and perform, reducing the risk for injury. Each stretch should start slowly until you reach a point of muscle tension. Stretching should not be painful. Aim to hold each stretch for up to 20 seconds.
  • Use the right equipment or gear and wear shoes that provide support  and that may correct certain foot problems that can lead to injury.
  • Learn the right techniques to play your sport.
  • Rest when tired, Avoid exercise when you are tired or in pain.
  • Always take your time during strength training and go through the full range of motion with each repetition.
  • If you do sustain a sports injury, make sure you participate in adequate rehabilitation before resuming strenuous activity.

Cast Types and Maintenance Instructions

Photo of girl with cast on arm

What is a cast?

A cast holds a broken bone in place as it heals. Casts also help to prevent or decrease muscle contractions, and are effective at providing immobilization, especially after surgery.

Casts immobilize the joint above and the joint below the area that is to be kept straight and without motion. For example, a child with a forearm fracture will have a long arm cast to immobilize the wrist and elbow joints.

What are casts made of?

The outside, or hard part of the cast, is made from two different kinds of casting materials.

  • Plaster (white in color)
  • Fiberglass (comes in a variety of colors, patterns, and designs)

Cotton and other synthetic materials are used to line the inside of the cast to make it soft and to provide padding around bony areas, such as the wrist or elbow.

Special waterproof cast liners may be used under a fiberglass cast, allowing the child to get the cast wet. Consult your child’s doctor for special cast care instructions for this type of cast.

What are the different types of casts?

Below is a description of the various types of casts, the location of the body they are applied, and their general function.

Type of cast Location Uses
Short arm cast Applied below the elbow to the hand. Forearm or wrist fractures. Also used to hold the forearm or wrist muscles and tendons in place after surgery.
Long arm cast Applied from the upper arm to the hand. Upper arm, elbow, or forearm fractures. Also used to hold the arm or elbow muscles and tendons in place after surgery.
Arm cylinder cast Applied from the upper arm to the wrist. To hold the elbow muscles and tendons in place after a dislocation or surgery.
Illustrations of arm casts, 3 types
Click Image to Enlarge
Type of cast Location Uses
Shoulder spica cast Applied around the trunk of the body to the shoulder, arm, and hand. Shoulder dislocations or after surgery on the shoulder area.
Minerva cast Applied around the neck and trunk of the body. After surgery on the neck or upper back area.
Short leg cast Applied to the area below the knee to the foot. Lower leg fractures, severe ankle sprains/strains, or fractures. Also used to hold the leg or foot muscles and tendons in place after surgery to allow healing.
Leg cylinder cast Applied from the upper thigh to the ankle. Knee, or lower leg fractures, knee dislocations, or after surgery on the leg or knee area.
Illustrations of leg casts, 3 types
Click Image to Enlarge
Type of cast Location Uses
Unilateral hip spica cast Applied from the chest to the foot on one leg. Thigh fractures. Also used to hold the hip or thigh muscles and tendons in place after surgery to allow healing.
One and one-half hip spica cast Applied from the chest to the foot on one leg to the knee of the other leg. A bar is placed between both legs to keep the hips and legs immobilized. Thigh fracture. Also used to hold the hip or thigh muscles and tendons in place after surgery to allow healing.
Bilateral long leg hip spica cast Applied from the chest to the feet. A bar is placed between both legs to keep the hips and legs immobilized. Pelvis, hip, or thigh fractures. Also used to hold the hip or thigh muscles and tendons in place after surgery to allow healing.
Illustrations of hip spica casts, 3 types
Click Image to Enlarge
Type of cast Location Uses
Short leg hip spica cast Applied from the chest to the thighs or knees. To hold the hip muscles and tendons in place after surgery to allow healing.
Illustration of child wearing a short leg hip spica cast
Click Image to Enlarge
Type of cast Location Uses
Abduction boot cast Applied from the upper thighs to the feet. A bar is placed between both legs to keep the hips and legs immobilized. To hold the hip muscles and tendons in place after surgery to allow healing.
Illustration of child wearing abduction boots
Click Image to Enlarge

How can my child move around while in a cast?

Assistive devices for children with casts include:

  • Crutches
  • Walkers
  • Wagons
  • Wheelchairs
  • Reclining wheelchairs

Cast care instructions

  • Keep the cast clean and dry.
  • Check for cracks or breaks in the cast.
  • Rough edges can be padded to protect the skin from scratches.
  • Do not scratch the skin under the cast by inserting objects inside the cast.
  • Can use a hairdryer placed on a cool setting to blow air under the cast and cool down the hot, itchy skin. Never blow warm or hot air into the cast.
  • Do not put powders or lotion inside the cast.
  • Cover the cast while your child is eating to prevent food spills and crumbs from entering the cast.
  • Prevent small toys or objects from being put inside the cast.
  • Elevate the cast above the level of the heart to decrease swelling.
  • Encourage your child to move his or her fingers or toes to promote circulation.
  • Do not use the abduction bar on the cast to lift or carry the child.

Older children with body casts may need to use a bedpan or urinal in order to go to the bathroom. Tips to keep body casts clean and dry and prevent skin irritation around the genital area include the following:

  • Use a diaper or sanitary napkin around the genital area to prevent leakage or splashing of urine.
  • Place toilet paper inside the bedpan to prevent urine from splashing onto the cast or bed.
  • Keep the genital area as clean and dry as possible to prevent skin irritation.

When to call your child’s doctor

Contact your child’s doctor or healthcare provider if your child develops one or more of the following symptoms:

  • Fever as directed by your healthcare provider or:
    •    Your child is younger than 12 weeks and has a fever of 100.4°F (38°C) or higher because your baby may need to be seen by their healthcare provider.
    •    Your child has repeated fevers above 104°F (40°C) at any age.
    •    Your child is younger than 2 years old and their fever continues for more than 24 hours or your child is 2 years old and older and their fever continues for more than 3 day
  • Increased pain
  • Increased swelling above or below the cast
  • Decreased ability to move extremity in the cast
  • Complaints of numbness or tingling
  • Drainage or foul odor from the cast
  • Cool or cold fingers or toes
  • If the cast becomes wet or soiled
  • Blister, sores, or rash develop under the cast

Sprains, Strains, Breaks: What’s the Difference?

If you’ve sprained your ankle, you know what severe pain is.

But maybe that “sprain” was a “strain” or possibly even a “break.”

The amount of pain in each case can be virtually equal. So, oftentimes the only way to find out what you have is to see a healthcare provider.

Just the facts

Here are some facts on musculoskeletal injuries:

  • Sprains are a stretch and/or tear of a ligament, the tissue connecting 2 bones. Ligaments stabilize and support the body’s joints. For example, ligaments in the knee connect the upper leg with the lower leg. This lets you walk and run.
  • Strains are a twist, pull and/or tear of a muscle and/or tendon. Tendons are cords of tissue that connect muscles to bones.
  • Breaks are a fracture, splinter or complete break in bone, often caused by accidents, sports injuries or bone weakness.

Sprains

A sprain is caused by an injury that stresses a joint and overstretches or even ruptures supporting ligaments. This can happen from a fall, twist, or blow to the body,

In a mild sprain, a ligament is stretched, but the joint remains stable and is not loosened. A moderate sprain partially tears the ligament, causing the joint to be unstable. With a severe sprain, ligaments tear completely or separate from the bone. This loosening interferes with how the joint functions. You may feel a tear or pop in the joint. Although the intensity varies, all sprains commonly cause pain, swelling, bruising, and inflammation.

The ankle is the most commonly sprained joint. And a sprained ankle is more likely if you’ve had a previous sprain there. Repeated sprains can lead to ankle arthritis, a loose ankle or tendon injury.

Strains

Acute strains are caused by stretching or pulling a muscle or tendon. Chronic strains are the result of overuse of muscles and tendons, through prolonged, repetitive movement. Not getting enough rest during intense training can cause a strain.

Typical symptoms of strain include:

  • Pain
  • Muscle spasm
  • Muscle weakness
  • Swelling
  • Inflammation
  • Cramping

In severe strains, the muscle and/or tendon is partially or completely ruptured, resulting in serious injury. Some muscle function will be lost with a moderate strain, in which the muscle/tendon is overstretched and slightly torn. With a mild strain, the muscle or tendon is stretched or pulled, slightly.

These are some common strains:

  • Back strain. This happens when the muscles that support the spine are twisted, pulled, or torn. Athletes who engage in excessive jumping—during basketball or volleyball, for example—are at risk for this injury.
  • Hamstring muscle strain. This is when a major muscle in the back of the thigh tears or stretches. The injury can sideline a person for up to 6 months. The likely cause is muscle strength imbalance between the hamstrings and the quadriceps, the muscles in the front of the thigh. Kicking a football, running, or leaping to make a basket can pull a hamstring. Hamstring injuries tend to happen again.

Breaks

Bone breaks, unlike sprains and strains, should always be looked at by a healthcare provider to ensure proper healing. Call your healthcare provider if the pain does not lessen or if the bone appears to be deformed. Seek urgent medical care if you have numbness, weakness, or poor circulation in the injured limb.

Athletes are most susceptible

All sports and exercises, even walking, carry a risk of sprains. The areas of the body most at risk for a sprain depend on the specific activities involved. For example, basketball, volleyball, soccer, and other jumping sports share a risk for foot, leg and ankle sprains.

Soccer, football, hockey, boxing, wrestling, and other contact sports put athletes at risk for strains. So do sports that feature quick starts, like hurdling, long jump, and running races. Gymnastics, tennis, rowing, golf, and other sports that require extensive gripping put participants at higher risk for hand strains. Elbow strains often happen in racquet, throwing, and contact sports.

Treating injuries

A severe sprain or strain may need surgery or immobilization, followed by physical therapy. Mild sprains and strains may need rehab exercises and a change in activity during recovery.

In all but mild cases, your healthcare provider should evaluate the injury and establish a treatment and rehab plan.

Meanwhile, rest, ice, compression and elevation (called RICE) usually will help minimize damage caused by sprains and strains. Start RICE right away after the injury.

RICE relieves pain, limits swelling, and speeds healing. It’s often the best treatment for soft-tissue injuries, like sprains and strains. Here’s what to do:

  • Rest buy generic propranolol. Move the injured area as little as possible to allow healing to begin.
  • Ice. Apply ice right away to reduce inflammation, which causes more pain and slows healing. Cover the injured area with an ice pack wrapped in a thin towel for about 15 to 20 minutes, 3 to 4 times a day.
  • Compression. Using a pressure bandage helps prevent or reduce swelling. Use an elastic bandage. Wrap the injured area without making it so tight that it will cut off the blood supply.
  • Elevation. Raise the injured area above the level of the heart. Prop up a leg or arm while resting it. You may need to lie down to get your leg above your heart level.

Do all 4 parts of the RICE treatment at the same time. If you think you have a more serious injury, like a broken bone, call your healthcare provider right away.

Prevention

No one is immune to sprains and strains. But here are some tips to help reduce your risk for injury:

  • Take part in a conditioning program to build muscle strength.
  • Do stretching exercises every day.
  • Always wear shoes that fit properly.
  • Nourish your muscles by eating a well-balanced diet.
  • Warm up before any sports activity, including practice, and use or wear protective equipment that’s right for that sport.
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