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.

A Breathing Technique Offers Help for People With Asthma

By JANE E. BRODY

Published: November 2, 2009 

 

 I don’t often write about alternative remedies for serious medical conditions. Most have little more than anecdotal support, and few have been found effective in well-designed clinical trials. Such trials randomly assign patients to one of two or more treatments and, wherever possible, assess the results without telling either the patients or evaluators who received which treatment.

Now, however, in describing an alternative treatment for asthma that does not yet have top clinical ratings in this country (although it is taught in Russian medical schools and covered by insurance in Australia), I am going beyond my usually stringent research criteria for three reasons:
¶The treatment, a breathing technique discovered half a century ago, is harmless if practiced as directed with a well-trained therapist.
¶It has the potential to improve the health and quality of life of many people with asthma, while saving health care dollars.
¶I’ve seen it work miraculously well for a friend who had little choice but to stop using the steroid medications that were keeping him alive.
My friend, David Wiebe, 58, of Woodstock, N.Y., is a well-known maker of violins and cellos, with a 48-year history of severe asthma that was treated with bronchodilators and steroids for two decades. Ten years ago, Mr. Wiebe noticed gradually worsening vision problems, eventually diagnosed as a form of macular degeneration caused by the steroids. Two leading retina specialists told him to stop using the drugs if he wanted to preserve his sight.
He did, and endured several terrifying trips to the emergency room when asthma attacks raged out of control and forced him to resume steroids temporarily to stay alive.
Nothing else he tried seemed to work. “After having a really poor couple of years with significantly reduced quality of life and performance at work,” he told me, “I was ready to give up my eyesight and go back on steroids just so I could breathe better.”
Treatment From the ’50s
Then, last spring, someone told him about the Buteyko method, a shallow-breathing technique developed in 1952 by a Russian doctor, Konstantin Buteyko. Mr. Wiebe watched a video demonstration on YouTube and mimicked the instructions shown.
“I could actually feel my airways relax and open,” he recalled. “This was impressive. Two of the participants on the video were basically incapacitated by their asthma and on disability leave from their jobs. They each admitted that keeping up with the exercises was difficult but said they had been able to cut back on their medications by about 75 percent and their quality of life was gradually returning.”
A further search uncovered the Buteyko Center USA in his hometown, newly established as the official North American representative of the Buteyko Clinic in Moscow.
“When I came to the center, I was without hope,” Mr. Wiebe said. “I was using my rescue inhaler 20 or more times in a 24-hour period. If I was exposed to any kind of irritant or allergen, I could easily get a reaction that jeopardized my existence and forced me to go back on steroids to save my life. I was a mess.”
But three months later, after a series of lessons and refresher sessions in shallow breathing, he said, “I am using less than one puff of the inhaler each day — no drugs, just breathing exercises.”
Mr. Wiebe doesn’t claim to be cured, though he believes this could eventually happen if he remains diligent about the exercises. But he said: “My quality of life has improved beyond my expectations. It’s very exciting and amazing. More people should know about this.”
Ordinarily, during an asthma attack, people panic and breathe quickly and as deeply as they can, blowing off more and more carbon dioxide. Breathing rate is controlled not by the amount of oxygen in the blood but by the amount of carbon dioxide, the gas that regulates the acid-base level of the blood.
Dr. Buteyko concluded that hyperventilation — breathing too fast and too deeply — could be the underlying cause of asthma, making it worse by lowering the level of carbon dioxide in the blood so much that the airways constrict to conserve it.
This technique may seem counterintuitive: when short of breath or overly stressed, instead of taking a deep breath, the Buteyko method instructs people to breathe shallowly and slowly through the nose, breaking the vicious cycle of rapid, gasping breaths, airway constriction and increased wheezing.
The shallow breathing aspect intrigued me because I had discovered its benefits during my daily lap swims. I noticed that swimmers who had to stop to catch their breath after a few lengths of the pool were taking deep breaths every other stroke, whereas I take in small puffs of air after several strokes and can go indefinitely without becoming winded.
The Buteyko practitioners in Woodstock, Sasha and Thomas Yakovlev-Fredricksen, were trained in Moscow by Dr. Andrey Novozhilov, a Buteyko disciple. Their treatment involves two courses of five sessions each: one in breathing technique and the other in lifestyle management. The breathing exercises gradually enable clients to lengthen the time between breaths. Mr. Wiebe, for example, can now take a breath after more than 10 seconds instead of just 2 while at rest.
Responses May Vary
His board-certified pulmonologist, Dr. Marie C. Lingat, told me: “Based on objective data, his breathing has improved since April even without steroids. The goal now is to make sure he maintains the improvement. The Buteyko method works for him, but that doesn’t mean everyone who has asthma would respond in the same way.”
In an interview, Mrs. Yakovlev-Fredricksen said: “People don’t realize that too much air can be harmful to health. Almost every asthmatic breathes through his mouth and takes deep, forceful inhalations that trigger a bronchospasm,” the hallmark of asthma.
“We teach them to inhale through the nose, even when they speak and when they sleep, so they don’t lose too much carbon dioxide,” she added.
At the Woodstock center, clients are also taught how to deal with stress and how to exercise without hyperventilating and to avoid foods that in some people can provoke an asthma attack.
The practitioners emphasize that Buteyko clients are never told to stop their medications, though in controlled clinical trials in Australia and elsewhere, most have been able to reduce their dependence on drugs significantly. The various trials, including a British study of 384 patients, have found that, on average, those who are diligent about practicing Buteyko breathing can expect a 90 percent reduction in the use of rescue inhalers and a 50 percent reduction in the need for steroids within three to six months.
The British Thoracic Society has given the technique a “B” rating, meaning that positive results of the trials are likely to have come from the Buteyko method and not some other factor. Now, perhaps, it is time for the pharmaceutically supported American medical community to explore this nondrug technique as well.
 

Study Finds the Availability of Chiropractic Care Improves the Value of Health Benefits Plans

Foundation for Chiropractic Progress commissions landmark report delivers incremental impact on population health and total health care spending

Carmichael, CA - October 20, 2009 - A report, prepared by a global leader for trusted human resources and related financial advice, products and services, finds that the addition of chiropractic care for the treatment of low back and neck pain will likely increase value-for-dollar in US employer-sponsored health benefit plans. Authored by Niteesh Choudhry, MD, PhD, and Arnold Milstein, MD, the report can be fully downloaded at:

http://images.vortala.com/chiropractor/USA/California/Carmichael/Foundation%20for%20Chiropractic%20Progress/SiteGraphics/ChiropracticServicesReport.pdf

Accordingly, this report was commissioned by the Foundation for Chiropractic Progress (www.f4cp.com) to summarize the existing economic studies of chiropractic care published in peer-reviewed scientific literature, and to use the most robust of these studies to estimate the cost-effectiveness of providing chiropractic insurance coverage in the US.

According to Gerard Clum, DC, spokesperson for the Foundation for Chiropractic Progress and President of Life Chiropractic College West, ?While some studies reflect cost efficiencies and others clinical efficiencies, these findings strongly support both for chiropractic care of neck pain and low back pain.?

Executive Summary:

Low back and neck pain are extremely common conditions that consume large amounts of health care resources. Chiropractic care, including spinal manipulation and mobilization, are used by almost half of US patients with persistent back-pain seeking out this modality of treatment.

The peer-reviewed scientific literature evaluating the effectiveness of US chiropractic treatment for patients with back and neck pain suggests that these treatments are at least as effective as other widely used treatments. However, US cost-effectiveness studies have methodological limitations.

High quality randomized cost-effectiveness studies have to date only been performed in the European Union (EU). To model the EU study findings for US populations, researchers applied US insurer-payable unit price data from a large database of employer-sponsored health plans. The findings rest on the assumption that the relative difference in the cost-effectiveness of low back and neck pain treatment with and without chiropractic services are similar in the US and the EU.

The results of the researchers' analysis are as follows:

-Effectiveness: Chiropractic care is more effective than other modalities for treating low back and neck pain.

Total cost of care per year:

-For low back pain, chiropractic physician care increases total annual per patient spending by $75 compared to medical physician care.

-For neck pain, chiropractic physician care reduces total annual per patient spending by $302 compared to medical physician care.

Cost-effectiveness: When considering effectiveness and cost together, chiropractic physician care for low back and neck pain is highly cost-effective, represents a good value in comparison to medical physician care and to widely accepted cost-effectiveness thresholds.

These findings, in combination with existing US studies published in peer-reviewed scientific journals, suggest that chiropractic care for the treatment of low back and neck pain is likely to achieve equal or better health outcomes at a cost that compares very favorable to most therapies that are routinely covered in US health benefits plans. As a result, the addition of chiropractic coverage for the treatment of low back and neck pain at prices typically payable in US employer-sponsored health benefit plans will likely increase value-for-dollar by improving clinical outcomes and either reducing total spending (neck pain) or increasing total spending (low back pain) by a smaller percentage than clinical outcomes improve.

Anatomy of the Cervical spine

http://www.youtube.com/watch?v=aDvbAvBLQuM

Depressing News about Treatment of Depression

Note from Brian O'Hea

This article is from Dr. Andrew Weil M.D., who was one of the first MD's to popularize the field of "integrative medicine." This looks at the whole person and addresses lifestyle, nutrition, exercise etc. to help people be healthier. "Integrative Medicine" is much like the version of chiropractic care that Dr. Susan and I preach. The big difference is that we don't prescribe medications. We believe that most of the time your body heals itself. In fact, it's doing so right now.

On another note, I just read the book Generation RX by Greg Crister. It is how the pharmaceutical companies turn the everyday emotions and conditions that we all experience into maladies that can be fixed with the magic pill. The book details how drug companies create new markets and profit handsomely by doing so. There is a glimmer of hope at the end of the book on how we can create our own state of health and well-being. Well worth reading.

And now the Article......


Depression can be devastating. Its worst form, major depressive disorder, is marked by all-encompassing low mood, thoughts of worthlessness, isolation, and loss of interest or pleasure in most or all activities. But this clinical description misses the deep, experiential horror of the condition; the suffocating sense of despair that can make life seem too arduous to bear.
Here's something else we can say confidently about depression: it is complex. The cause is often a mix of factors including genetic brain abnormalities, sunlight deprivation, poor nutrition, lack of exercise, and social issues including homelessness and poverty. Also, cause and effect can be hard to tease apart -- is social isolation a cause or an effect of depression?
Unfortunately, we can make one more unassailable observation about depression: the disorder -- or, more precisely, the diagnosis -- has gone stratospheric. An astonishing 10 percent of the U.S. population was prescribed an antidepressant in 2005; up from 6 percent in 1996.
Why has the diagnosis become so popular? There are likely several reasons. It's possible that more people today are truly depressed than they were a decade ago. Urbanized, sedentary lifestyles; nutrient-poor processed food; synthetic but unsatisfying entertainments and other negative trends, all of which are accelerating, may be driving up the rate of true depression. But I doubt the impact of these trends has nearly doubled in just ten years.
So here's another possibility. The pharmaceutical industry is cashing in.
In 1996, the industry spent $32 million on direct-to-consumer (DTC) antidepressant advertising. By 2005, that nearly quadrupled, to $122 million. It seems to have worked. More than 164 million antidepressant prescriptions were written in 2008, totaling $9.6 billion in U.S. sales. Today, the television commercial is ubiquitous:
A morose person stares out of a darkened room through a rain-streaked window.
Quick cut to a cheery logo of an SSRI (selective serotonin reuptake inhibitor, the most common type of antidepressant pharmaceutical).
Cross-fade to the same person, medicated and smiling, emerging into sunlight to pick flowers, ride a bicycle or serve birthday cake to laughing children.
A voiceover gently suggests, "Ask your doctor if [name of drug] is right for you."

The message -- all sadness is depression, depression is a chemical imbalance in the brain, this pill will make you happy, your doctor will get it for you -- could not be clearer. The fact that the ad appears on television, the ultimate mass medium, also implies that depression is extremely common.
Yet a study published in the April, 2007, issue of the Archives of General Psychiatry, based on a survey of more than 8,000 Americans, concluded that estimates of the number who suffer from depression at least once during their lifetimes are about 25 percent too high. The authors noted that the questions clinicians use to determine if a person is depressed don't account for the possibility that the person may be reacting normally to emotional upheavals such as a lost job or divorce (only bereavement due to death is accounted for in the clinical assessment). And a 15-year study by an Australian psychiatrist found that of 242 teachers, more than three-quarters met the criteria for depression. He wrote that depression has become a "catch-all diagnosis."
What's going on?
It's clear that depression, a real disorder, is being exploited by consumer marketing and is over-diagnosed in our profit-driven medical system. Unlike hypertension or high cholesterol -- which have specific, numerical diagnostic criteria -- a diagnosis of depression is ultimately subjective. Almost any average citizen (particularly one who watches a lot of television) can persuade him or herself that transient, normal sadness is true depression. And far too many doctors are willing to go along.
The solution to this situation is, unsurprisingly, complex, cutting across social, medical, political and cultural bounds. But here are three major changes that are needed immediately:
Medically, thousands of studies confirm that depression, particularly mild to moderate forms, can be alleviated by lifestyle changes. These include exercise, lowered caffeine intake, diets high in fruits and vegetables, and certain supplements, particularly omega-3 fatty acids. Physicians need to be trained in these methods, as they are at the Arizona Center for Integrative Medicine at the University of Arizona in Tucson. See Natural Depression Treatment for more about these low-tech methods, or the "Depression" chapter in the excellent professional text, Integrative Medicine by David Rakel, M.D. (Saunders, 2007).
Politically, if Congress -- which seems hopelessly addicted to watering down all aspects of health care reform -- can't manage to ban all DTC ads in one stroke, it should start by immediately ending those for antidepressants.
Personally, be skeptical of all DTC ads for antidepressants. The drugs may turn out to be no more effective than placebos. Many of them have devastating side effects, and withdrawal, even if done gradually, can be excruciating. While they can be lifesavers for some people, in most cases they should be employed only after less risky and expensive lifestyle changes have been tried.

Finally, recognize that no one feels good all the time. An emotionally healthy person can, and probably should, stare sadly out of a window now and then. Many cultures find the American insistence on constant cheerfulness and pasted-on smiles disturbing and unnatural. Occasional, situational sadness is not pathology -- it is part and parcel of the human condition, and may offer an impetus to explore a new, more fulfilling path. Beware of those who attempt to make money by convincing you otherwise.
Andrew Weil, M.D


Read more at: http://www.huffingtonpost.com/andrew-weil-md/are-you-depressed-or-just_b_307734.html

Run, Run, Run, Run Away...

The above is a reference to a line from a Jefferson Starship (or if you are an old hippie, the Jefferson Airplane) song and a lead in to a few of my thoughts on running. I often get asked if running is ok on the body, especially if you have a neck or back injury. And the answer is a resounding maybe! It depends on a bunch of factors-such as the severity of your problem, health of your joints (like your knees and hips), patterns of muscle imbalances, and your feet. Everyone is a little different and there isn't one simple answer.
Let me explain some of the ways you can get from where you are ( maybe sitting on the couch) to a place you would like to be (active, jogging, maybe competing in a race). First off, I start by looking at your feet. If your arches are flat or you notice your shoes wearing more on the outside of the heel, you probably need to start with orthotics. Orthotics are inserts that you put into your shoes to correct biomechanical problems in your gait. I use (both personally in my own shoes and in my practice) FootMaxx orthotics. They have a great method at determining the type of foot problem you have an have a semirigid orthotic that is comfortable to wear. Most of the patients at the office really feel they are helpful. Orthotics not only help your feet, but they can relieve pressure on your knees and back.
Next, I will see if any of the muscles in your legs are tight and imbalanced. It's very common to have a tight hamstring or ITB and it is important to deal with this. Otherwise, running will continue to strengthen the imbalance. People often have tight hamstrings; what I have learned ( and some recent research has shown) is that you can stretch and stretch and stretch your hamstrings, but they won't get any more flexible until you fix your back.
So what if your joints are already worn out? If you have a lot of wear and tear on your joints ( arthritis) walk, don't run. Sorry. You can make your walks more interesting by varying your pace. You can also get a nice heart work-out by carrying two water bottles in your hands and occasionally pumping them above your head. This was the idea behind the "heavy hand" wrist weights that were popular in the early 80's. Even though I don't recommend running, you need to walk, especially if you have arthritis. The right amount of movement and pressure stimulates cartilage growth. Supplements for joint health are a great ides and will be covered in a future post.
What about shoes? I can't keep up with all the brands so I recommend you get fit at a local store, Running in Motion, in Edmonds. The owner, Frank, knows his stuff. He put me in a size larger than I normally use and they feel good. The concept is that feet swell when you run so a tight fitting shoes gets too tight when you are exercising.
IF you "don't have a runners body" just remember that you do. It's in there, it just needs some help to come out.

How To Fix Bad Ankles

By Gretchen Reynolds

Ankles provide a rare opportunity to recreate a seminal medical study in the comfort of your own home. Back in the mid-1960s, a physician, wondering why, after one ankle sprain, his patients so often suffered another, asked the affected patients to stand on their injured leg (after it was no longer sore). Almost invariably, they wobbled badly, flailing out with their arms and having to put their foot down much sooner than people who’d never sprained an ankle. With this simple experiment, the doctor made a critical, if in retrospect, seemingly self-evident discovery. People with bad ankles have bad balance.Remarkably, that conclusion, published more than 40 years ago, is only now making its way into the treatment of chronically unstable ankles. “I’m not really sure why it’s taken so long,” says Patrick McKeon, an assistant professor in the Division of Athletic Training at the University of Kentucky. “Maybe because ankles don’t get much respect or research money. They’re the neglected stepchild of body parts.”

At the same time, in sports they’re the most commonly injured body part — each year approximately eight million people sprain an ankle. Millions of those will then go on to sprain that same ankle, or their other ankle, in the future. “The recurrence rate for ankle sprains is at least 30 percent,” McKeon says, “and depending on what numbers you use, it may be high as 80 percent.”

A growing body of research suggests that many of those second (and often third and fourth) sprains could be avoided with an easy course of treatment. Stand on one leg. Try not to wobble. Hold for a minute. Repeat.

This is the essence of balance training, a supremely low-tech but increasingly well-documented approach to dealing with unstable ankles. A number of studies published since last year have shown that the treatment, simple as it is, can be quite beneficial.

In one of the best-controlled studies to date, 31 young adults with a history of multiple ankle sprains completed four weeks of supervised balance training. So did a control group with healthy ankles. The injured started out much shakier than the controls during the exercises. But by the end of the month, those with wobbly ankles had improved dramatically on all measures of balance. They also reported, subjectively, that their ankles felt much less likely to give way at any moment. The control group had improved their balance, too, but only slightly. Similarly, a major review published last year found that six weeks of balance training, begun soon after a first ankle sprain, substantially reduced the risk of a recurrence. The training also lessened, at least somewhat, the chances of suffering a first sprain at all.

Why should balance training prevent ankle sprains? The reasons are both obvious and quite subtle. Until recently, clinicians thought that ankle sprains were primarily a matter of overstretched, traumatized ligaments. Tape or brace the joint, relieve pressure on the sore tissue, and a person should heal fully, they thought. But that approach ignored the role of the central nervous system, which is intimately tied in to every joint. “There are neural receptors in ligaments,” says Jay Hertel, an associate professor of kinesiology at the University of Virginia and an expert on the ankle. When you damage the ligament, “you damage the neuro-receptors as well. Your brain no longer receives reliable signals” from the ankle about how your ankle and foot are positioned in relation to the ground. Your proprioception — your sense of your body’s position in space — is impaired. You’re less stable and more prone to falling over and re-injuring yourself.

For some people, that wobbliness, virtually inevitable for at least a month after an initial ankle sprain, eventually dissipates; for others it’s abiding, perhaps even permanent. Researchers don’t yet know why some people don’t recover. But they do believe that balance training can return the joint and its neuro-receptor function almost to normal.

Best of all, if you don’t mind your spouse sniggering, you can implement state-of-the-art balance training at home. “We have lots of equipment here in our lab” for patients to test, stress, and improve their balance, Hertel says. “But all you really need is some space, a table or wall nearby to steady yourself if needed, and a pillow.” (If you’ve recently sprained your ankle, wait until you comfortably can bear weight on the joint before starting balance training.) Begin by testing the limits of your equilibrium. If you can stand sturdily on one leg for a minute, cross your arms over your chest. If even that’s undemanding, close your eyes. Hop. Or attempt all of these exercises on the pillow, so that the surface beneath you is unstable. “One of the take-home exercises we give people is to stand on one leg while brushing your teeth, and to close your eyes if it’s too easy,” Hertel says. “It may sound ridiculous, but if you do that for two or three minutes a day, you’re working your balance really well.”

Nutrition and Exercise

JULY 2, 2009, 1:29 PM
Eating to Fuel Exercise

By TARA PARKER-POPE
Leslie Bonci
No matter what kind of exercise you do – whether it’s a run, gym workout or bike ride – you need food and water to fuel the effort and help you recover.

But what’s the best time to eat before and after exercise? Should we sip water or gulp it during a workout? For answers, I spoke with Leslie Bonci, director of sports nutrition at the University of Pittsburgh Medical Center and a certified specialist in sports dietetics. She’s also the author of a new book, “Sports Nutrition for Coaches” (Human Kinetics Publishers, July 2009). Here’s our conversation.

How important is the timing and type of food and fluid when it comes to exercise?

I take the approach of thinking of food as part of your equipment. People are not going to run well with one running shoe or ride with a flat tire on their bike. Your food is just like your running shoes or your skis. It really is the inner equipment. If you think of it this way, you usually have a better outcome when you’re physically active.

What’s the most common mistake you see new exercisers make when it comes to food?

There are two common mistakes. Often somebody is not having anything before exercise, and then the problem is you’re not putting fuel into your body. You’ll be more tired and weaker, and you’re not going to be as fast.

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The second issue is someone eats too much. They don’t want to have a problem, so they load up with food, and then their stomach is too full. It’s really a fine line for getting it right.

At what point before exercise should we be eating?

I like it to be an hour before exercise. We’re just talking about a fist-sized amount of food. That gives the body enough food to be available as an energy source but not so much that you’ll have an upset stomach. So if you’re going to exercise at 3 p.m., you need to start thinking about it at 2 p.m.

What about water? How much should we be drinking?

About an hour before the workout you should have about 20 ounces of liquid. It takes about 60 minutes for that much liquid to leave the stomach and make its way into the muscle. If you have liquid ahead of time, you’ll be better hydrated when you start to be physically active.

Can you explain more about what you mean by a “fist-size” of food?

That’s just a good visual for the amount. It could be something along the lines of a granola bar. I’m not a fan of the low carb bars. You need carbs as an energy source. We can’t really just do a protein bar. You want something in the 150 to 200 calorie range. That’s not enormous. Maybe a peanut butter and jelly wrap cut into little pieces, a fist-sized amount of trail mix. The goal is to put some carbohydrate in the body before exercise as well as a little bit of protein.

What if I’m planning a long run or bike ride that’s going to keep me out for a few hours? Should I eat more?

If we put too much food in the stomach in advance of exercise, it takes too long to empty and that defeats the purpose. We want something that will empty fairly quickly. If you’re exercising in excess of one hour, then you need to fuel during the exercise. For workouts lasting more than an hour, aim for about 30 to 60 grams of carbs per hour. We’re not going to be camels here. Some people use gels, honey or even sugar cubes or a sports drink.

Does the timing of your food after you’re finished exercising make any difference?

Post exercise, my rule of thumb, I like for people to eat something within 15 minutes. The reason for that is that the enzymes that help the body re-synthesize muscle glycogen are really most active in that first 15 minutes. The longer we wait to eat something, the longer it takes to recover.

If people are really embarking on an exercise program and want to prevent that delayed-onset muscle soreness, refueling is part of it. Again, it’s a small amount – a fist-sized quantity. Low-fat chocolate milk works very well. The goal is not a post-exercise meal. It’s really a post-exercise appetizer to help the body recover as quickly as it can. You can do trail mix, or make a peanut butter sandwich. Eat half before and half after.

Why is it that peanut butter sandwiches come up so often as good fuel for exercise?

It’s about having carbohydrate with some protein. It’s inexpensive and nonperishable. That’s a big deal for people, depending on the time of day and year. They’re exercising and they don’t want something that will spoil. Peanut butter is an easy thing to keep around.

What do we need to know about replenishing fluids as we exercise?

Everybody has a different sweat rate, so there isn’t one amount of liquid that someone is going to need while they exercise. Most people consume about 8 ounces per hour – that’s insufficient across the board. Your needs can range from 14 ounces to 40 ounces per hour depending on your sweat rate. Those people who are copious sweaters need to make an effort to get more fluid in while they exercise. I’m a runner, and I can’t depend on water fountains, so either someone is carrying water or you bring money. Store keepers always love that when you give them sweaty bills!

But nobody can be a camel. If you aren’t taking fluid in you have a risk of heat injury and joint injury, and strength, speed and stamina diminish. This is an important part of any training. Put fluid back into the body during exercise.

Should we keep sipping fluids while we’re exercising?

How we drink can make a difference in how optimally we hydrate our body. A lot of people sip liquids, but gulping is better. Gulps of fluid leave the stomach more rapidly. It’s important to do this. It seems counterintuitive, it seems like gulping would cause a cramp. People are more likely to have stomach cramps sipping because fluid stays in their gut too long.

When you take more fluid in, gulps as opposed to sips, you have a greater volume of fluid in the stomach. That stimulates the activity of the stretch receptors in the stomach, which then increase intra-gastric pressure and promote faster emptying. This is why gulping is preferred.

Do you have any recommendations about the frequency of meals for people who exercise regularly?

If you have breakfast, lunch and dinner and a pre- and post-exercise snack, that’s at least five times a day of eating. When people are physically active, anything under three meals a day is not going to be enough.

Tour de Lance

Quote Of The Week

"Pain is temporary. It may last a minute, or an hour, or a day, or a year, but eventually it will subside and something else will take its place. If I quit, however, it lasts forever."

Lance Armstrong
Cancer Survivor and Athlete

Energy and Sports Drinks: Any Better Than Soda?

Remember when water was the drink of choice for athletes and just about anyone who needed to quench their thirst? These days, water is quickly being replaced with a variety of energy drinks, flavored waters and sports drinks - and they're being consumed at all hours of the day, not just after a workout or during an athletic competition.

Energy Drinks

One of the major health concerns with energy drinks is their caffeine content: up to 80 mg of caffeine per serving. According to Brown University, that's more than twice the caffeine in a can of Mountain Dew and more than three times the caffeine in a can of Coca Cola Classic. Too much caffeine can elevate the heart rate, increase blood pressure, and lead to insomnia. (Some manufacturers have now come out with decaffeinated versions, although that hasn't seemed to particularly impact the popularity of the caffeinated varieties.)

A recent study that investigated potential safety issues in energy drinks reveals that most energy drinks also contain some combination of natural products such as guarana, taurine and ginseng. And let's not forget about sugar, one of the major ingredients in addition to caffeine. Average sugar content can exceed 35 grams per can, according to the study.¹ (Sugar-free versions of some energy drinks are available, but remember, there are plenty of sugarfree sodas out there, and none of them has health benefits, either.)

Perhaps the most telling point appears in the authors' conclusion: "The amounts of guarana, taurine, and ginseng found in popular energy drinks are far below the amounts expected to deliver either therapeutic benefits or adverse events. However, caffeine and sugar are present in amounts known to cause a variety of adverse health effects."

According to Brown University, energy drinks should never be consumed while exercising, as they tend to promote dehydration, which can be dangerous when combined with fluid loss from sweating. They also should not be combined with alcohol (they often are); the former is a stimulant and the latter is a depressant, which can be a bad combination. And again, both tend to promote dehydration.

Sports Drinks and Flavored Waters

If you think sports drinks or flavored, vitamin-infused waters are any better than energy drinks, you may want to think again. Sure, they may not be filled with caffeine, but they definitely still have sugar and other additives, and according to a recent study, those added ingredients may contribute to dental problems.

In fact, studies have shown that the combination of sugar, acidic ingredients and additives in some sports drinks can damage tooth enamel to a larger degree than soda. A recent study presented at the International Association for Dental Research meeting in Miami affirms this, with study results suggesting sports drinks - including Gatorade, Vitamin Water, Life Water, Powerade and Propel Fit - cause softening of the dentin, while some may even "significantly" stain the teeth.²

"Sugar is bad, and acid is bad, but many of these [sports drinks and flavored waters] have both. The combination causes tooth decay," said Kimberly Harms, spokesperson for the American Dental Association.³

How to Garden without Breaking Your Back

Now that the weather is starting to warm up, a lot of our patients are heading out into the garden. Who can resist the allure of fresh air, sunshine, the feel of dirt in their hands, and the promise of delicious, homegrown fruits and vegetables? It's a wonderful thing to grow some of your own food. But gardening is an inherently challenging activity for people who have any kind of weakness in the back, so it's important to take precautions while in the garden.


Why does gardening cause back problems?
Part of the reason gardening causes back problems is that it's a weekend warrior activity. You go for months and months without gardening, and then you end up doing a physically demanding activity for an extended period of time that your body isn't used to doing. In particular, gardening involves a lot of forward bending, which loads a tremendous amount of pressure on the discs and joints. The Oklahoma State University website does a good job of explaining this phenomenon:

Think of your back as a lever. With the fulcrum in the center of the lever, it only takes ten pounds of pressure to lift a ten pound object. However, if you shift the fulcrum to the side, it takes much more force to lift the same object. Your waist actually acts like the fulcrum in a lever system, and it is not centered. In fact, it operates on a 10:1 ratio. Lifting a ten pound object actually puts 100 pounds of pressure on your lower back. When you add in the 105 pounds of the average human upper torso, you see that lifting a ten pound object actually puts 1,150 pounds of pressure on your lower back.[i]

Oftentimes, not only are you bent forward when you're gardening, but you're attaching something to the end of your hand, like a shovel with a mound of dirt, which makes the lever even longer and thus puts even more pressure on your back.

[1] Oklahoma State University. Back Safety. http://ehs.okstate.edu/kopykit/Back%20Safety.pdf

Tips for pain-free gardening

1. Be careful of forward bending for too long
Don't bend over in an uncontrolled position for hours and hours. Either kneel, sit on a little stool, or figure out what the best posture position is for you.

2. Take frequent breaks
Every 30 minutes, get up and stretch your back. Even short breaks can prevent back injuries.

3. Do backward bending exercises
To counteract all that forward bending, do some backward bending exercises if they work for you.

4. Hire out the hard stuff
If you need to do some digging, and digging is really hard on your back, hire someone to dig for an hour for you. The rest will be easy!

5. Quit when your back feels tired
If you feel your back starting to get tired or painful, stop. Frequently injuries happen when the back is tired.

Remember, a lot of chronic back problems start with either minor tears in the discs or strains to the ligaments, and those things can easily occur with gardening. That doesn't mean you shouldn't garden. Gardening gives you an opportunity to connect to the earth in a very profound and deep way. So do it, just take care of yourself while doing it!

Sincerely,

Marc Heller Matt Terreri