Many patients experiencing back or joint pain will ask if it is caused by osteoporosis. This common question highlights just how high a profile the disease has gained in recent years. Osteoporosis itself has no symptoms, including pain, but the loss of bone density can lead to degeneration of the spine, Dowager’s hump, and fragile bones susceptible to fracture. While osteoporosis is serious, it is fortunately a treatable condition.
Orthopedic surgeons only rarely treat osteoporosis, since the disease is readily combatted by diet, exercise, supplements, and when needed, medication. Post-menopausal women should – even in the absence of bone fractures – be tested for osteoporosis, and studies show that men are also increasingly at risk for the disease.
Why have fragility fractures caused by osteoporosis reached epidemic levels among aging Americans? The two primary causes are our modern diet and sedentary lifestyle.
Like eggshells and seashells, bones are made primarily of calcium, and are thus strong but inflexible, and with a loss of density, can break just like an eggshell. Merely adding calcium to the diet is not adequate, in that calcium uptake by the body is affected by other substances; for example, despite the fact that the largely fish diet of Eskimo women provides over 2000 mg of calcium a day, and even though exercise is a regular part of their life, they are known to have one of the highest rates of osteoporosis in the world. The excess fat and protein in their diet prevent calcium absorption.
So in addition to improving your diet, what’s way to avoid becoming a part of this “silent epidemic”? Move! Our sedentary lifestyle is our worst enemy. As you grow older, continue to walk, dance, jump rope; play tennis, basketball, and golf; do Pilates and have fun in a Zumba class. All of these weight-bearing exercises help build strong bones.
Try some yoga too. Yoga will limber you up, and keeping limber is also great prevention, as nearly 80% of fragility fractures are a result of falls.
The longer you can stay flexible, balanced, and upright, the better chance you have of avoiding the pain – not of osteoporosis, but of the debilitating breakage of bone they so often cause.
For treatment of osteoporosis, please consult your PRIMARY CARE PHYSICIAN, GYNECOLOGIST, or ENDOCRINOLOGIST. The orthopedic surgeons at Manhattan Orthopedic and Sports Medicine, ONLY TREAT
THE UNFORTUNATE CONSEQUENCES of this treatable disease.
Stay active and avoid fractures!
For runners, the arrival of fall means more than just shorter days and longer sleeves. Fall foliage signals a critical time of the year, when our bodies deserve special attention. Especially for those anticipating marathon or other demanding competitive events, there is a tendency to increase mileage on training runs, which can be a recipe for disaster. In these first weeks of autumn, we should take a lesson from the trees – cut back, slow down. As the trees drop their leaves, you can afford to drop a few miles from your weekly mileage, as a safeguard against injury.
We often see an increase in injuries at this season, and you should be vigilant in heeding any early warning signs – swelling, mild discomfort, tenderness – that suggest you are exceeding your body’s limits. Resist the temptation to push through when pain arises; it is always better to adjust your training schedule modestly now, rather than lose your momentum altogether due to an injury. Early recognition is a key to maintaining health.
Not all warnings come in the form of pain. Irritability, insomnia, or a change in appetite can be signs of impending injury or illness. A simple rule-of-thumb is to measure your resting heart rate in the morning, then gear your workout in relationship to this. Autumn is a good time to assess your equipment, after a full summer season. How are your shoes? 300 to 500 miles, or 3 to 6 months, is the normal duration before replacing your running shoes.
At any season, Achilles tendonitis and plantar fasciitis represent particularly painful challenges to the runner. A patient recently reported that a fellow runner recommended a Castor oil compress to facilitate heeling of a sore Achilles. A much more effective remedy is a night splint, which, by holding the foot in a dorsiflexed position, provides a passive stretch through 8 hours of sleep. Other treatment approaches might include supportive footwear, arch taping, and physical therapy.
Remember though, if you have persistent pain, we are here to help you. Just give us a ring!
At age 70, most of us find that we have slowed down in our physical activity: no more 4-mile runs 3 to 5 times per week; no more tennis twice a week; nor a round of golf on the weekends. Bit-by-bit, we reduce our exercise program. We cut back on our running distance or frequency, or perhaps trade in our running shoes for a bicycle. We switch from singles to doubles. We play 9 holes of gold instead of 18 – or, heaven forbid, use a golf cart!
Even with this reduced activity, we often find aches and pains that were not there when we were younger – our rotator cuffs are worn; our discs have lost their elasticity; our cartilage in some joints may be worn. For all the pain and stiffness we feel, this is no reason to give up regular exercise.
We just need to alter our rhythms, and add new strategies in order to maintain a sufficient range of motion and strength. For some of us, the simple addition of alternative therapies – chiropractic; acupuncture; supplements – will be enough to maintain our health; for others, we may need regular PT visits, or injection therapy.
Our primary care physician should make sure there are no more serious issues – rheumatoid arthritis; Lyme disease; vitamin deficiencies; even muscle weakness arising from the commonly prescribed lipid-lowering drugs – to which we should stay alert. Following this a visit to your orthopedic surgeon is in order.
No part of our body has served us so faithfully through a lifetime of movement than our joints, and an orthopedic surgeon can insure that they keep serving us. Most suggested orthopedic treatments will be non-surgical, but there may be occasions where an arthroscopic procedure, a trigger finger release, a carpal tunnel release or a microdiscectomy would allow us to return to a high level of activity. The physicians at Manhattan Orthopedic and Sports Medicine Group are available to evaluate all your aches and pains.
The mantra for the aging athlete of all abilities is: “Modify, but never give up!” With the assistance of our doctors and other health care professionals, all of us greying golfers, tennis players, cyclists, and rollerbladers can achieve this.
Age brings wisdom, and following this wise path of modified activity, we can all keep exercising right into our 90s!
These days there are countless fitness clubs to join, exercise classes to sample, and workout videos to download. But with all these options, which is the best? Let’s consider some popular choices.
The treadmill, elliptical machine and stationary bike are all popular in the gym. They deliver a healthy cardio workout making all three are a good choice. The stationary bike, however, allows for low-impact aerobic exercise (as opposed to the high impact activity on the treadmill). Biking, therefore, may be a particularly good choice for those recovering from hip or knee injuries.
When it comes to core strength and joint flexibility, Yoga is an excellent option. Limber joints and muscles are key to preventing injury, and yoga is an excellent way to maintain flexibility. It also emphasizes balance and stability, which is an added bonus.
High impact, high intensity exercise programs through classes at the gym or on DVDs or computers are also popular. These programs can be an excellent way to achieve a total body workout and improve conditioning. They may not be for everyone though. Athletes who participate in these programs should be sure to stretch both before and after. They should also carefully monitor their participation to avoid muscle strains or other over-use injuries.
Swimming is another excellent choice and now with the warmer weather, offers a healthy cardio workout. It is low impact on the joints and is an excellent option for those recovering from injuries including back and spine pain, hip and knee pain.
Ultimately, there is no perfect single way to exercise. In fact, one of the best ways to work out is to vary your exercises and to participate in a number of different types of activities. Varying your exercises allows you to involve different muscle groups. And it helps prevent over-use injuries.
Plus, it keeps things interesting! So go out and try something new. Your muscles and joints will thank you for it.