McGill's Hip Airplane-Training for your gluts (butt muscles)

Love your Knees, You will miss them when they are Gone

Squat, Lunge Exercises Could Save Young Knees

6:00 pm

January 14, 2010

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By Brenda Wilson

Girls love playing soccer almost as much as boys do, with more than a third of soccer players in this country likely to have a pony tail or pixie cut, according to the U.S. Soccer Federation.

But that popularity has come with a price.

New exercises may help prevent women's knee injuries. (Eraxion /istockphoto.com)

Girls are three times more likely to injure their knees playing soccer than boys -- with some studies finding six times as many of these injuries among girls. It's one particular injury that's causing the most problems: a tear of the anterior cruciate ligament, or ACL. It can put a player out of commission for up to 6 months, and can have lifelong consequences, such as early onset of osteoarthritic symptoms.

A Swedish team whose study appears in this week's Archives of Internal Medicine shows that it is possible to avoid these injuries in girls. The team -- including a physician, an orthopedic surgeon, a physiotherapist and coaches for female soccer players -- designed a regimen that reduced the injuries by 77 percent when compared to other teams that didn't use the same techniques.

Independent experts who've reviewed the study disagree with the amount of protection the study claims, but they do say there is a real benefit. Previous studies show that such exercise regimens have been able to reduce injuries by half.

The regimen -- called HarmoKnee -- involves a series of warm-up exercises and muscle movements such as jogging, high-knee skipping, lunges, squats and curls. It's designed to change motion patterns so that there is less strain on the knee joint, particularly the ligament that links the upper leg bone with the lower one. (Here are some examples: the lateral single leg jump, the knee squat, and the board.

The researchers found that if girls routinely use the techniques, key muscles around the knee are strengthened and balance is improved.

Ideally, says Tim Hewitt a neuromuscular expert in charge of an injury prevention program at Cincinnati Children's Hospital, these exercises should start before girls reach puberty, so that they will be prepared when changes in their body make them more prone to injury.

During puberty, the body takes on mass faster than muscles can develop the power to coordinate. Hewett says if young girls are trained to do the exercises early enough, like junior high school, they develop enough neuromuscular control -- strength and coordination -- to help protect their knees through and after their growth spurt.

But programs like HarmoKnee have found few takers in athletic programs in the United States. The regimen is a big time investment, with players in the Swedish study undertaking it twice a week in the pre-season and once a week during the regular season.

That may be one reason why just 1 to 2 percent of programs in the United States use the regimens, even though researchers here have been trying to get the word out about just how important they ar

Sugar May Be Bad But This Sweetener Is Far More Deadly

Study after study are taking their place in a growing lineup of scientific research demonstrating that consuming high-fructose corn syrup is the fastest way to trash your health. It is now known without a doubt that sugar in your food, in all it's myriad of forms, is taking a devastating toll.
And fructose in any form -- including high-fructose corn syrup (HFCS) and crystalline fructose -- is the worst of the worst!
Fructose is a major contributor to:
• Insulin resistance and obesity
• Elevated blood pressure
• Elevated triglycerides and elevated LDL
• Depletion of vitamins and minerals
• Cardiovascular disease, liver disease, cancer, arthritis and even gout
A Calorie is Not a Calorie
Glucose is the form of energy you were designed to run on. Every cell in your body, every bacterium -- and in fact, every living thing on the Earth--uses glucose for energy.
If you received your fructose only from vegetables and fruits (where it originates) as most people did a century ago, you'd consume about 15 grams per day -- a far cry from the 73 grams per day the typical adolescent gets from sweetened drinks. In vegetables and fruits, it's mixed in with fiber, vitamins, minerals, enzymes, and beneficial phytonutrients, all which moderate any negative metabolic effects.
It isn't that fructose itself is bad -- it is the MASSIVE DOSES you're exposed to that make it dangerous.
There are two reasons fructose is so damaging:
1. Your body metabolizes fructose in a much different way than glucose. The entire burden of metabolizing fructose falls on your liver.
2. People are consuming fructose in enormous quantities, which has made the negative effects much more profound.
Today, 55 percent of sweeteners used in food and beverage manufacturing are made from corn, and the number one source of calories in America is soda, in the form of HFCS.
Food and beverage manufacturers began switching their sweeteners from sucrose (table sugar) to corn syrup in the 1970s when they discovered that HFCS was not only far cheaper to make, it's about 20 percent sweeter than table sugar.
HFCS is either 42 percent or 55 percent fructose, and sucrose is 50 percent fructose, so it's really a wash in terms of sweetness.
Still, this switch drastically altered the average American diet.
By USDA estimates, about one-quarter of the calories consumed by the average American is in the form of added sugars, and most of that is HFCS. The average Westerner consumes a staggering 142 pounds a year of sugar! And the very products most people rely on to lose weight -- the low-fat diet foods -- are often the ones highest in fructose.
Making matters worse, all of the fiber has been removed from these processed foods, so there is essentially no nutritive value at all.
Fructose Metabolism Basics
Without getting into the very complex biochemistry of carbohydrate metabolism, it is important to understand some differences about how your body handles glucose versus fructose. I will be publishing a major article about this in the next couple of months, which will get much more into the details, but for our purpose here, I will just summarize the main points.
Dr. Robert Lustig[i] Professor of Pediatrics in the Division of Endocrinology at the University of California, San Francisco, has been a pioneer in decoding sugar metabolism. His work has highlighted some major differences in how different sugars are broken down and used:
• After eating fructose, 100 percent of the metabolic burden rests on your liver. But with glucose, your liver has to break down only 20 percent.
• Every cell in your body, including your brain, utilizes glucose. Therefore, much of it is "burned up" immediately after you consume it. By contrast, fructose is turned into free fatty acids (FFAs), VLDL (the damaging form of cholesterol), and triglycerides, which get stored as fat.
• The fatty acids created during fructose metabolism accumulate as fat droplets in your liver and skeletal muscle tissues, causing insulin resistance and non-alcoholic fatty liver disease (NAFLD). Insulin resistance progresses to metabolic syndrome and type II diabetes.
• Fructose is the most lipophilic carbohydrate. In other words, fructose converts to activated glycerol (g-3-p), which is directly used to turn FFAs into triglycerides. The more g-3-p you have, the more fat you store. Glucose does not do this.
• When you eat 120 calories of glucose, less than one calorie is stored as fat. 120 calories of fructose results in 40 calories being stored as fat. Consuming fructose is essentially consuming fat!
• The metabolism of fructose by your liver creates a long list of waste products and toxins, including a large amount of uric acid, which drives up blood pressure and causes gout.
• Glucose suppresses the hunger hormone ghrelin and stimulates leptin, which suppresses your appetite. Fructose has no effect on ghrelin and interferes with your brain's communication with leptin, resulting in overeating.
If anyone tries to tell you "sugar is sugar," they are way behind the times. As you can see, there are major differences in how your body processes each one.
The bottom line is: fructose leads to increased belly fat, insulin resistance and metabolic syndrome -- not to mention the long list of chronic diseases that directly result.
Panic in the Corn Fields
As the truth comes out about HFCS, the Corn Refiners Association is scrambling to convince you that their product is equal to table sugar, that it is "natural" and safe.
Of course, many things are "natural" -- cocaine is natural, but you wouldn't want to use 142 pounds of it each year.
The food and beverage industry doesn't want you to realize how truly pervasive HFCS is in your diet -- not just from soft drinks and juices, but also in salad dressings and condiments and virtually every processed food. The introduction of HFCS into the Western diet in 1975 has been a multi-billion dollar boon for the corn industry.
The FDA classifies fructose as GRAS: Generally Regarded As Safe. Which pretty much means nothing and is based on nothing.
There is plenty of data showing that fructose is not safe -- but the effects on the nation's health have not been immediate. That is why we are just now realizing the effects of the last three decades of nutritional misinformation.
As if the negative metabolic effects are not enough, there are other issues with fructose that disprove its safety:
• More than one study has detected unsafe mercury levels in HFCS[ii].
• Crystalline fructose (a super-potent form of fructose the food and beverage industry is now using) may contain arsenic, lead, chloride and heavy metals.
• Nearly all corn syrup is made from genetically modified corn, which comes with its own set of risks.
The FDA isn't going to touch sugar, so it's up to you to be proactive about your own dietary choices.
What's a Sugarholic to Do?
Ideally, I recommend that you avoid as much sugar as possible. This is especially important if you are overweight or have diabetes, high cholesterol, or high blood pressure.
I also realize we don't live in a perfect world, and following rigid dietary guidelines is not always practical or even possible.
If you want to use a sweetener occasionally, this is what I recommend:
1. Use the herb stevia.
2. Use organic cane sugar in moderation.
3. Use organic raw honey in moderation.
4. Avoid ALL artificial sweeteners, which can damage your health even more quickly than fructose.
5. Avoid agave syrup since it is a highly processed sap that is almost all fructose. Your blood sugar will spike just as it would if you were consuming regular sugar or HFCS. Agave's meteoric rise in popularity is due to a great marketing campaign, but any health benefits present in the original agave plant are processed out.
6. Avoid so-called energy drinks and sports drinks because they are loaded with sugar, sodium and chemical additives. Rehydrating with pure, fresh water is a better choice.
If you or your child is involved in athletics, I recommend you read my article Energy Rules for some great tips on how to optimize your child's energy levels and physical performance through good nutrition.
[i] Robert H. Lustig, MD: UCSF Faculty Bio Page, and YouTube presentation "Sugar: The bitter truth" and "The fructose epidemic" The Bariatrician, 2009, Volume 24, No. 1, page 10)
[ii] "Why is the FDA unwilling to study evidence of mercury in high-fructose corn syrup?" 20 Feb 2009, Grist
Dr. Joseph Mercola is the founder and director of Mercola.com. Become a fan of Dr. Mercola on Facebook, on Twitter and check out Dr. Mercola's report on sun exposure!

Knee problems, Meniscal Repair

Questions About Meniscus Injury, Surgery, Rehab

Dr. O'Hea's Comments:

 This is an excellent  response  to a  question about knee injuries; specifically about injury to the cartilage pad on the outer sides of the  knee  called the meniscus.  It explains how you can  recover on your own and on  what you can  expect if your injury is too far gone and you need surgery.

 I'm a big believer in letting these injuries heal on their own whenever possible. You will need some guidance from a chiropractor or therapist to assist in your recovery.   This post is from the blog of  Doug Kelsey PT, a great therapist/author in Austin, Tejas.

Hi Doug,

I recently came across your blog while searching for answers on a ACL and meniscus injury. I’m fairly new to this as my wife recently had an injury in her gym where her left knee popped. After the instructed popped it back in, and couple of x-rays, few weeks of physiotherapy, and an MRI, 6 weeks later the orthopedic surgeon told us that she has a torn ACL and tear of medial cartilage (meniscus). He also mentioned that he couldn’t see any ACL fragments so it could be from an earlier injury which happened 18 years ago and we have no record of it as to what happened other than that left knee has been weak.

I have quite a few questions for which I received different responses from different people so will try to compile them here so that others can benefit too.

1)    I’ve read that meniscus can repair/heal itself. To what extent is this true? It seems like outer shell of meniscus has blood flow so there might be a chance of healing a tear on the outside.

2)    In case of a meniscus tear or a fold-in, does it need to be cut in a curved fashion? And if can heal, then can the cut now heal itself?

3)    I’ve heard that if you don’t cut the meniscus away then it might result in degeneration. What would happen if it just degenerates itself without actually cutting it thru a surgery? How long does a cut meniscus take to degenerate?

4)    The ortho advised that the meniscus surgery needs to happen within 6 weeks of the injury… I haven’t been able to find any such reference although people say sooner the better. What’s sooner here and what if it’s not too soon but still sooner than later?

5)    I’ve also read a lot about the rehabilitation programs and trying those first (even one of your blog entry from 2006) so in what cases this is helpful? Can physiotherapy help with my wife’s case?

6)    The full recovery period after an ACL and meniscus surgery has been told to be 3 months to 6 months? Can one fully recover to 100% in six months (playing soccer, doing gym etc).. assuming they are within 80-90% of the cases who recover fully. Even though they recover, I’d assume that they have more chances of subsequent injury as compared to a other people. Right?

7)     How long to absorbable bioscrews take to dissolve? There are people with partially dissolved screws after 2 years.

I really appreciate your knowledge and time to respond to this and I’d be willing to add more information to the blog so others might find it informative and useful.

Best Regards,

-H

****

Thanks for reading and for the questions. I'll do my best.

Ok, first off H, the best answers come following an interview and exam. Everything else is guesswork really. There's just no substitute for the process. The internet is the great democratizer of information. What it lacks however is judgment; wisdom. We all have the same bones, muscles, cartilage, etc. yet we're different people with different needs. Clinicians use the data from the history and exam and run that through an "experience filter" to arrive at an answer for you (or your wife). So, my advice is meet with several clinicians and ask the same questions you listed above.

Meniscus tears that are in the more vascular part of the tissue, generally the outer 1/3, have a better chance for healing. If a surgeon can repair the tissue, he or she will usually try. Whenever you remove part or certainly all of the meniscus, you increase the chance for early onset of osteoarthritis due to a change in contact pressures in the knee. The meniscus gets some of its nutrients via the synovial fluid and responds to mechanical pressure in a similar way to articular cartilage so movement and controlled loading usually help.

As far as a surgery time line, I have noticed, and the literature tends to support this, that surgeries go better when the knee is not swollen at the time of surgery. So, if you tear the ACL and your knee swells, which it usually does, most surgeons will wait for the swelling to go down. If you don't, the risk of arthrofibrosis or scarring in the joint, goes up.

We've had clients with partial meniscal tears, some operated on and some not, who have done quite well in rehab as well as folks with meniscal repairs. But, as I mentioned earlier, this is very case dependent. The rehab programs are all custom built based on the person's unique mix of needs, problems, and goals.

Your question about full recovery is a good one and I think what you're asking about is the physical recovery.  But, there's recovery and then there's restoration. The difference is that recovery is a physical process. Tissues heal. Motion returns. Strength increases. But restoration is a mental-emotional-physical process and for some this takes a long time. When you have an injury that sends you to surgery, disrupts your life, perhaps even your livelihood, you have to make some adjustments; accept reality and do things you basically don't want to do. And you usually need a coach or someone to help you through it. Some people are restored to a place of wholeness in months; some years; some I suspect never really make it (for example, their leg is strong but they don't totally trust it).

But, back to your question about physical recovery, the record holder at Sports Center returned to sport level activity in 61 days. But, most people reach athletic capability in 6 to 9 months. However, if you've had articular surface damage, it usually takes longer - 12 to 18 months or more. There are a number of factors that come into play - the type of procedure used, the extent of damage to your knee, how your body responds to surgery or how rapidly you form scar tissue, how adherent you are to post-op instructions (and how thorough the instructions are), your pain tolerance, how your knee responds to load and the type of rehab you go through as well. Tiger Woods was out for 8 months and more than one surgeon believed at the time of surgery that it would take him 24 months to get back into his pre-surgery condition (of course, that's been interrupted due to his personal problems).

And for your last question, bioabsorbable screws are not something we have much to do with but from what I've read, those usually take 18 to 24 months to be absorbed.

"Food Rules": A Completely Different Way To Fix The Health Care Crisis

 By Michael Pollan

The idea for this book came from a doctor--a couple of them, as a matter of fact. They had read my last book, "In Defense of Food", which ended with a handful of tips for eating well: simple ways to navigate the treacherous landscape of modern food and the often-confusing science of nutrition. "What I would love is a pamphlet I could hand to my patients with some rules for eating wisely," they would say. "I don't have time for the big nutrition lecture and, anyway, they really don't need to know what an antioxidant is in order to eat wisely." Another doctor, a transplant cardiologist, wrote to say "you can't imagine what I see on the insides of people these days wrecked by eating food products instead of food." So rather than leaving his heart patients with yet another prescription or lecture on cholesterol, he gives them a simple recipe for roasting a chicken, and getting three wholesome meals out of it -- a very different way of thinking about health.
Make no mistake: our health care crisis is in large part a crisis of the American diet -- roughly three quarters of the two-trillion plus we spend on health care in this country goes to treat chronic diseases, most of which can be prevented by a change in lifestyle, especially diet. And a healthy diet is a whole lot simpler than the food industry and many nutritional scientists -- what I call the Nutritional Industrial Complex -- would have us believe. After spending several years trying to answer the supposedly incredibly complicated question of how we should eat in order to be maximally healthy, I discovered the answer was shockingly simple: eat real food, not too much of it, and more plants than meat. Or, put another way, get off the modern western diet, with its abundance of processed food, refined grains and sugars, and its sore lack of vegetables, whole grains and fruit.
So I decided to take the doctors up on the challenge. I set out to collect and formulate some straightforward, memorable, everyday rules for eating, a set of personal policies that would, taken together or even separately, nudge people onto a healthier and happier path. I solicited rules from doctors, scientist, chefs, and readers, and then wrote a bunch myself, trying to boil down into everyday language what we really know about healthy eating. And while most of the rules are backed by science, they are not framed in the vocabulary of science but rather culture -- a source of wisdom about eating that turns out to have as much, if not more, to teach us than nutritional science does.
What follows is a small sample of "Food Rules", a half dozen policies that will give you a taste of what you'll find in the book: sixty-four food rules, each with a paragraph of explanation. I think you'll see from this little appetizer that "Food Rules" is a most unconventional diet book. You can read it in an hour and it just might change your eating life. I hope you'll take away something you can put to good use, and maybe get a chuckle or two along the way. And do let me know if have any food rules I should know about. I'm still collecting them, at pollanfoodrules@gmail.com.
#11 Avoid foods you see advertised on television.

Food marketers are ingenious at turning criticisms of their products -- and rules like these -- into new ways to sell slightly different versions of the same processed foods: They simply reformulate (to be low-fat, have no HFCS or transfats, or to contain fewer ingredients) and then boast about their implied healthfulness, whether the boast is meaningful or not. The best way to escape these marketing ploys is to tune out the marketing itself, by refusing to buy heavily promoted foods. Only the biggest food manufacturers can afford to advertise their products on television: More than two thirds of food advertising is spent promoting processed foods (and alcohol), so if you avoid products with big ad budgets, you'll automatically be avoiding edible foodlike substances. As for the 5 percent of food ads that promote whole foods (the prune or walnut growers or the beef ranchers), common sense will, one hopes, keep you from tarring them with the same brush -- these are the exceptions that prove the rule.
From "Food Rules":
#19 If it came from a plant, eat it; if it was made in a plant, don't.
#36 Don't eat breakfast cereals that change the color of the milk.
This should go without saying. Such cereals are highly processed and full of refined carbohydrates as well as chemical additives.

#39 Eat all the junk food you want as long as you cook it yourself.
There is nothing wrong with eating sweets, fried foods, pastries, even drinking soda every now and then, but food manufacturers have made eating these formerly expensive and hard-to-make treats so cheap and easy that we're eating them every day. The french fry did not become America's most popular vegetable until industry took over the jobs of washing, peeling, cutting, and frying the potatoes -- and cleaning up the mess. If you made all the french fries you ate, you would eat them much less often, if only because they're so much work. The same holds true for fried chicken, chips, cakes, pies, and ice cream. Enjoy these treats as often as you're willing to prepare them -- chances are good it won't be every day.


#47 Eat when you are hungry, not when you are bored.
For many of us, eating has surprisingly little to do with hunger. We eat out of boredom, for entertainment, to comfort or reward ourselves. Try to be aware of why you're eating, and ask yourself if you're really hungry -- before you eat and then again along the way. (One old wive's test: If you're not hungry enough to eat an apple, then you're not hungry.) Food is a costly antidepressant.
#58 Do all your eating at a table.
No, a desk is not a table. If we eat while we're working, or while watching TV or driving, we eat mindlessly -- and as a result eat a lot more than we would if we were eating at a table, paying attention to what we're doing. This phenomenon can be tested (and put to good use): Place a child in front of a television set and place a bowl of fresh vegetables in front of him or her. The child will eat everything in the bowl, often even vegetables that he or she doesn't ordinarily touch, without noticing what's going on. Which suggests an exception to the rule: When eating somewhere other than at a table, stick to fruits and vegetables.

Prelude

Prelude

by Oriah Mountain Dreamer

What if it truly doesn't matter what you do but how you do whatever you do?

How would this change what you choose to do with your life?

What if you could be more present and open-hearted with each person you encounter working as a cashier in the corner store, a parking lot attendant or filing clerk than you could if you were striving to do something you think is more important?

How would this change how you want to spend your precious time on this earth?

What if your contribution to the world and the fulfillment of you own happiness is not dependent upon discovering a better method of prayer or technique of meditation, not dependent upon reading the right book or attending the right seminar, but upon really seeing and deeply appreciating yourself and the world as they are right now?

How would this effect your search for spiritual development?

What if there is no need to change, no need to try and transform yourself into someone who is more compassionate, more present, more loving or wise?

How would this effect all the places in your life where you are endlessly trying to be better?

What if the task is simply to unfold, to become who you already are in your essential nature - gentle, compassionate and capable of living fully and passionately present?

How would this effect how you feel when you wake up in the morning?

What if who you essentially are right now is all that you are ever going to be?

How would this effect how you feel about your future?

What if the essence of who you are and always have been is enough?

How would this effect how you see and feel about your past?

What if the question is not why am I so infrequently the person I really want to be, but why do I so infrequently want to be the person I really am?

How would this change what you think you have to learn?

What if becoming who and what we truly are happens not through striving and trying but by recognizing and receiving the people and places and practises that offer us the warmth of encouragement we need to unfold?

How would this shape the choices you have to make about how to spend today?

What if you knew that the impulse to move in a way that creates beauty in the world will arise from deep within and guide you every time you simply pay attention and wait?

How would this shape your stillness, your movement, your willingness to follow this impulse, to just let go and dance?

Your Back

Advice on exercise and your lower back:

1. It is better to exercise a little every day then it is to do exercise more 3x/week.
2. Be careful in the early morning, your back is at it's greatest risk of injury (the discs and other tissues are stiff and not very flexible).
3. Back muscles are designed for endurance, not strength. Exercises that load the spine (such as using abdominal machines loaded with weights) can be really bad for you. If you are feeling pain, you are not likely getting any gain.