Arthritis – How Big a Problem & Why?
Ask the Doc……..
“It seems that more and more people I know have arthritis. How big a problem is this and why?”
Arthritis affects 70 million Americans. By 2030, it’s predicted that 67 million Americans will suffer from this debilitating disease. Arthritis has now become the number one cause of chronic pain and disability.
As a “senior citizen”, I’m seeing many of my friends unable to enjoy their retirement because of this painful, debilitating disease. Even a round of golf can leave many sore for days.
And what we’re doing clearly isn’t working. There are now more than 13 million Americans taking drugs and many others on supplements, attempting to alleviate their arthritic pain. Although helpful, supplements are like putting air in a leaky tire; treating after the fact; i.e. like pain medications, they do nothing to stop the cause of your arthritis.
When discomfort becomes too much, knees and hips are often replaced. Last year there were over half a million such joint replacements. If you haven’t had one yet, you surely known people who have. And that doesn’t end one’s problems as many complications can occur such as ending up with a leg that is longer or shorter than the other.
Medicine is for the most part still a “fix it” profession. And until more physicians begin to understand that despite current thinking, the major cause of osteoarthritis is not age or excessive weight (although certainly these are important factors) but abnormal alignment, these facts won’t change.
If age and weight were the primary factors, then why do we know people who are ninety and have no knee pain and some teenagers who do? There are also many people who are overweight who have no joint discomfort and others who are perfectly fit and suffer.
The major cause of osteoarthritis of our weight bearing joints (foot, ankle, knees, hips and back) is our abnormal structures, which increase friction on our joints and subsequently wears them out. This occurs in the same way that abnormally aligned car tires wear out unevenly and prematurely.
The latest data from institutions such as the Mayo Clinic, now confirms this; the primary cause of osteoarthritis of the weight bearing joints is improper alignment and not age!
If you want to stop arthritis you have to begin by more perfectly aligning how you function, (on a more permanent basis than just manipulation) and therefore decrease the stress on your joints.
A former reconstructive foot and ankle surgeon and past Clinical Instructor of Medicine at Emory University School of Medicine, Dr. Pack practices at MCG Medical Associates, Lake Oconee Village in Greensboro. He specializes in biomechanical structural analysis and works with patients who have arthritis and wish to decrease joint symptoms and remain active. Dr. Pack also treats athletes at all levels. In the 2004 Olympics he had a silver and gold medalist and helps the UGA Golf Team (2005 NCCA National Champions). For further information please see his web site at www.drloupack.com or contact him directly at 706-454-0040.
Friday, February 27, 2009
Wednesday, February 18, 2009
Best Exercise Equipment
Ask the Doc……
“What’s the best type of equipment to use to stay in shape?
February is Heart Health Month so your question is very timely. Elliptical machines, treadmills, rowing machines, and stationary bikes are all good pieces of equipment, each having advantages and disadvantages. While weight bearing exercise equipment is recommended, personal preference is often the determining factor.
I’m a runner and have been for over thirty five years, but I don’t usually recommend a treadmill. It’s very easy to trip and hurt yourself; especially if you’re older and your balance is already compromised.
To avoid tripping and get the greatest benefit from this type of equipment, you have to really pick your feet up. Since most people have tight calf muscles, and usually don’t stretch properly, that can be quite difficult and result in shin splints, calf pain, problems with heel spurs or plantar fasciiits (pain under the arch).
Elliptical machines provide the same weight bearing (standing) stress on your skeletal system (very much needed to prevent osteoporosis) without the pounding that even good treadmills can cause. They also hold your feet in place better than a treadmill, work your arms and upper body, and while doing so give you more to hold on to.
The major problem with elliptical equipment is discomfort on the bottoms of the feet. Some have ridges on the pedals used to prevent you from sliding. These are poorly designed and cause too much friction. For added comfort, I suggest putting a hard, thin piece of rubber (or some other type of cushioning material) on the pedals to eliminate these ridges.
But before beginning any exercise program, get a medical clearance from your physician. And to avoid problems, get a structural evaluation. Since no one is perfect, everyone has structural problems and the older we get the more significant they become.
I cannot begin to tell you how many patients I see who have gotten injured in their attempts to get into shape. For example, if you have a foot that pronates or rolls inward (flattens), it will cause your knee to turn inward too, causing pain. And for those with arthritis, this easily preventable and correctable problem can make exercise quite difficult if not impossible.
I’m all in favor of exercise. But to avoid damage to your joints and improve performance, just make sure you do so in proper alignment. Remember that, “health is something you can go through on the way to fitness.” Don’t become injured trying to get into shape!
A former reconstructive foot and ankle surgeon and past Clinical Instructor of Medicine at Emory University School of Medicine, Dr. Pack practices at MCG Medical Associates, in Greensboro. He specializes in biomechanical structural analysis and works with patients who have arthritis and wish to decrease joint symptoms and remain active. Dr. Pack also treats athletes at all levels. In the 2004 Olympics he had a silver and gold medalist and helps the UGA Golf Team (2005 NCCA National Champions). For further information please see www.drloupack.com, drloupack.blogspot.com or contact him directly at 706-454-0040.
Ask the Doc……
“What’s the best type of equipment to use to stay in shape?
February is Heart Health Month so your question is very timely. Elliptical machines, treadmills, rowing machines, and stationary bikes are all good pieces of equipment, each having advantages and disadvantages. While weight bearing exercise equipment is recommended, personal preference is often the determining factor.
I’m a runner and have been for over thirty five years, but I don’t usually recommend a treadmill. It’s very easy to trip and hurt yourself; especially if you’re older and your balance is already compromised.
To avoid tripping and get the greatest benefit from this type of equipment, you have to really pick your feet up. Since most people have tight calf muscles, and usually don’t stretch properly, that can be quite difficult and result in shin splints, calf pain, problems with heel spurs or plantar fasciiits (pain under the arch).
Elliptical machines provide the same weight bearing (standing) stress on your skeletal system (very much needed to prevent osteoporosis) without the pounding that even good treadmills can cause. They also hold your feet in place better than a treadmill, work your arms and upper body, and while doing so give you more to hold on to.
The major problem with elliptical equipment is discomfort on the bottoms of the feet. Some have ridges on the pedals used to prevent you from sliding. These are poorly designed and cause too much friction. For added comfort, I suggest putting a hard, thin piece of rubber (or some other type of cushioning material) on the pedals to eliminate these ridges.
But before beginning any exercise program, get a medical clearance from your physician. And to avoid problems, get a structural evaluation. Since no one is perfect, everyone has structural problems and the older we get the more significant they become.
I cannot begin to tell you how many patients I see who have gotten injured in their attempts to get into shape. For example, if you have a foot that pronates or rolls inward (flattens), it will cause your knee to turn inward too, causing pain. And for those with arthritis, this easily preventable and correctable problem can make exercise quite difficult if not impossible.
I’m all in favor of exercise. But to avoid damage to your joints and improve performance, just make sure you do so in proper alignment. Remember that, “health is something you can go through on the way to fitness.” Don’t become injured trying to get into shape!
A former reconstructive foot and ankle surgeon and past Clinical Instructor of Medicine at Emory University School of Medicine, Dr. Pack practices at MCG Medical Associates, in Greensboro. He specializes in biomechanical structural analysis and works with patients who have arthritis and wish to decrease joint symptoms and remain active. Dr. Pack also treats athletes at all levels. In the 2004 Olympics he had a silver and gold medalist and helps the UGA Golf Team (2005 NCCA National Champions). For further information please see www.drloupack.com, drloupack.blogspot.com or contact him directly at 706-454-0040.
Thursday, February 12, 2009
Running Faster
Ask the Doc……..
“My son wants to run faster. He has foot inserts but they haven’t helped. Do you have any suggestions?”
There are many factors involved in creating speed, one of the most important components in any sport. Among these are genetic predisposition, conditioning, coaching and determination. So his inserts may not be a factor at all. That said, a really good set of custom foot inserts can make all the difference in the world, but they must be extremely precise and unfortunately, most aren’t.
The normal foot (whether walking or running) hits the ground on the outside of the heel and then rolls inward (adapting to the surface). This motion is called pronation, and a certain amount of it is necessary. The problem is that most people pronate or roll in excessively. This is not only wasted, time consuming motion, but leads to all sorts of injuries.
The goal of a custom performance foot insert is to hold or stop the foot at its ideal position and not let it roll in any further. This allows the foot to be on the ground less time, which translates into faster speeds. The foot will also be a much more rigid, powerful lever, with quicker push off. That’s exactly why sprinters use a starting block; to have a more rigid lever to propel from. So an ideally corrected foot insert is like having a starting block in your shoe for every stride you take!
Studies have shown that if you can decrease the amount of time the foot is on the ground by only five one thousandths of a second, (and remember that a blink is one, one thousandth of a second,) you can decrease a forty yard dash time from 4.8 to 4.6 seconds or less. That’s a significant amount for a competitive athlete, and a really good set of custom inserts can do that.
But saying you have an insert or foot orthotic is like saying you have a car; that could mean just about anything. To work effectively, the foot must be casted in its ideal position and not the position it usually functions in. That means sitting and not standing, when abnormalities are seen. If the foot mold is made while standing, then these abnormalities are captured and the devices cannot be made as accurately.
So if everything else is in place, the reason your son isn’t running faster is probably because his inserts aren’t optimally corrective. There’s a difference in buying a pair of corrective eye glasses at a drug store and having prescription lenses made after seeing a real authority.
A former reconstructive foot and ankle surgeon and past Clinical Instructor of Medicine at Emory University School of Medicine, Dr. Pack practices at MCG Medical Associates, in Greensboro. He specializes in biomechanical structural analysis and works with patients who have arthritis and wish to decrease joint symptoms and remain active. Dr. Pack also treats athletes at all levels. In the 2004 Olympics he had a silver and gold medalist and helps the UGA Golf Team (2005 NCCA National Champions). For further information please see www.drloupack.com, drloupack.blogspot.com or contact him directly at 706-454-0040.
Ask the Doc……..
“My son wants to run faster. He has foot inserts but they haven’t helped. Do you have any suggestions?”
There are many factors involved in creating speed, one of the most important components in any sport. Among these are genetic predisposition, conditioning, coaching and determination. So his inserts may not be a factor at all. That said, a really good set of custom foot inserts can make all the difference in the world, but they must be extremely precise and unfortunately, most aren’t.
The normal foot (whether walking or running) hits the ground on the outside of the heel and then rolls inward (adapting to the surface). This motion is called pronation, and a certain amount of it is necessary. The problem is that most people pronate or roll in excessively. This is not only wasted, time consuming motion, but leads to all sorts of injuries.
The goal of a custom performance foot insert is to hold or stop the foot at its ideal position and not let it roll in any further. This allows the foot to be on the ground less time, which translates into faster speeds. The foot will also be a much more rigid, powerful lever, with quicker push off. That’s exactly why sprinters use a starting block; to have a more rigid lever to propel from. So an ideally corrected foot insert is like having a starting block in your shoe for every stride you take!
Studies have shown that if you can decrease the amount of time the foot is on the ground by only five one thousandths of a second, (and remember that a blink is one, one thousandth of a second,) you can decrease a forty yard dash time from 4.8 to 4.6 seconds or less. That’s a significant amount for a competitive athlete, and a really good set of custom inserts can do that.
But saying you have an insert or foot orthotic is like saying you have a car; that could mean just about anything. To work effectively, the foot must be casted in its ideal position and not the position it usually functions in. That means sitting and not standing, when abnormalities are seen. If the foot mold is made while standing, then these abnormalities are captured and the devices cannot be made as accurately.
So if everything else is in place, the reason your son isn’t running faster is probably because his inserts aren’t optimally corrective. There’s a difference in buying a pair of corrective eye glasses at a drug store and having prescription lenses made after seeing a real authority.
A former reconstructive foot and ankle surgeon and past Clinical Instructor of Medicine at Emory University School of Medicine, Dr. Pack practices at MCG Medical Associates, in Greensboro. He specializes in biomechanical structural analysis and works with patients who have arthritis and wish to decrease joint symptoms and remain active. Dr. Pack also treats athletes at all levels. In the 2004 Olympics he had a silver and gold medalist and helps the UGA Golf Team (2005 NCCA National Champions). For further information please see www.drloupack.com, drloupack.blogspot.com or contact him directly at 706-454-0040.
Friday, February 6, 2009
Arthritis and Your Weight
Ask the Doc…….
“Is weight the main cause of my arthritic knee?”
The famous Framingham Study found that knees and hips handle loads 2 ½ to 10 times the load of your body weight. So if you are 200 lbs, you may be having as much as 2000 pounds (1 ton) of pressure on your knees when you walk.
But medical facts can be misleading. There are many people who are significantly overweight that have no knee pain, and some who are very slender and have disabling symptoms. I also see many patients who are quite heavy and only have pain in one knee. So again, while it’s fair to say that increased weight is a factor, I don’t believe it’s the major factor, and the nearly 40 years of clinical experience I’ve had, certainly bears this out.
If weight increases joint stress because it puts more pressure on a joint, then logically, anything that increases pressure on a joint would also cause damage. And the factor that causes the most joint damage is not weight but abnormal structure, because the stress caused by abnormal structure is not evenly dispersed. A good example of this would be the tires on your car which obviously have to carry a great deal of weight. When properly aligned, they may last 50,000 miles. But when poorly aligned, they will wear unevenly and far faster, perhaps only lasting 10,000 miles.
A flattened foot or longer leg for example causes a knee to internally rotate (turn inward) and become damaged. Stand on the outside of your right foot and notice that the center of your knee is turned outward. Now flatten that foot, rolling it inward toward your left foot and notice how much this changes the position of your knee. When that knee is turned inward it doesn’t work in the position it’s supposed to and consequently more stress is placed on the inside of it. Now add extra weight and the problem is significantly magnified. This is when additional weight becomes a real factor; when placed on a poorly aligned joint!
So keeping your weight down is advised. But the best thing you can do for your knee pain is to have yourself evaluated structurally. Fixing simple things like a flattened foot or longer leg can make a world of difference in your comfort level. You may even find your golf game improving as well!
A former reconstructive foot and ankle surgeon and past Clinical Instructor of Medicine at Emory University School of Medicine, Dr. Pack practices at MCG Medical Associates, Lake Oconee Village in Greensboro. He specializes in biomechanical structural analysis and works with patients who have arthritis and wish to decrease joint symptoms and remain active. Dr. Pack also treats athletes at all levels. In the 2004 Olympics he had a silver and gold medalist and helps the UGA Golf Team (2005 NCCA National Champions). For further information please see www.drloupack.com, drloupack.blogspot.com or contact him directly at 706-454-0040.
Ask the Doc…….
“Is weight the main cause of my arthritic knee?”
The famous Framingham Study found that knees and hips handle loads 2 ½ to 10 times the load of your body weight. So if you are 200 lbs, you may be having as much as 2000 pounds (1 ton) of pressure on your knees when you walk.
But medical facts can be misleading. There are many people who are significantly overweight that have no knee pain, and some who are very slender and have disabling symptoms. I also see many patients who are quite heavy and only have pain in one knee. So again, while it’s fair to say that increased weight is a factor, I don’t believe it’s the major factor, and the nearly 40 years of clinical experience I’ve had, certainly bears this out.
If weight increases joint stress because it puts more pressure on a joint, then logically, anything that increases pressure on a joint would also cause damage. And the factor that causes the most joint damage is not weight but abnormal structure, because the stress caused by abnormal structure is not evenly dispersed. A good example of this would be the tires on your car which obviously have to carry a great deal of weight. When properly aligned, they may last 50,000 miles. But when poorly aligned, they will wear unevenly and far faster, perhaps only lasting 10,000 miles.
A flattened foot or longer leg for example causes a knee to internally rotate (turn inward) and become damaged. Stand on the outside of your right foot and notice that the center of your knee is turned outward. Now flatten that foot, rolling it inward toward your left foot and notice how much this changes the position of your knee. When that knee is turned inward it doesn’t work in the position it’s supposed to and consequently more stress is placed on the inside of it. Now add extra weight and the problem is significantly magnified. This is when additional weight becomes a real factor; when placed on a poorly aligned joint!
So keeping your weight down is advised. But the best thing you can do for your knee pain is to have yourself evaluated structurally. Fixing simple things like a flattened foot or longer leg can make a world of difference in your comfort level. You may even find your golf game improving as well!
A former reconstructive foot and ankle surgeon and past Clinical Instructor of Medicine at Emory University School of Medicine, Dr. Pack practices at MCG Medical Associates, Lake Oconee Village in Greensboro. He specializes in biomechanical structural analysis and works with patients who have arthritis and wish to decrease joint symptoms and remain active. Dr. Pack also treats athletes at all levels. In the 2004 Olympics he had a silver and gold medalist and helps the UGA Golf Team (2005 NCCA National Champions). For further information please see www.drloupack.com, drloupack.blogspot.com or contact him directly at 706-454-0040.
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