Ask the Doc………
“Is it a good idea to have my children’s feet checked? My Pediatrician has never really looked at them.”
Absolutely! Having your children’s feet checked is one of the most important things you can do for them.
Frankly, it’s very unfortunate that so little importance is relegated to the human foot by most health care professionals. Look at how much emphasis is placed on having your child’s teeth checked and they’re replaceable!
Your child’s feet are the foundation of their entire body. Many times the problems we see in children’s knees, hips and low back can be helped with proper foot positioning.
So having them examined is critical to their skeletal development. This is important in preventing bone and joint problems such as arthritis, and can help them perform better in sports.
A structural foot evaluation can also help them avoid sports injuries. I recently saw a young girl for example, who broke her foot while playing soccer. Contrary to what she was told, this wasn’t a soccer “injury.” The tight calf muscles she had, made it impossible for her to pick her feet up properly while running and so she tripped, twisting and breaking her foot.
When you consider that in their average lifetime, your child will walk over four times around the world and carry over nine hundred thousand billion lbs of pressure on their feet (now that’s a number!), it might not be a bad idea to prepare those two “orphan structures” at the end of their bodies for the journey! You certainly would do the same for the tires on your car if you planned an extended trip.
If a foot problem is identified, parents are usually told that their children will outgrow it. The truth is you don’t outgrow most foot problems but to the contrary, you grow into them; i.e., the flexible, usually easily correctible problems seen, become fixed, rigid, often painful problems as they grown and develop. So the earlier a child’s foot problems are identified, the easier it is to correct them.
As mentioned above, the foot is the foundation of our entire skeletal system. It supports all of the weight bearing joints of our ankles, knees, hips and back. Since many problems we see are preventable, if anyone in the family has arthritic problems in any of these areas, having your child’s feet examined becomes even more important.
Arthritis is the number one cause of pain and disability today. Recent data shows that the major cause is not age as we thought, but rather structural problems (like a longer leg or flattened foot). It is these structural problems that we inherit and that can be stopped in most instances in children.
Unlike dental exams which are routinely recommended, a thorough foot evaluation can be done much less often and still have profound positive effects.
A former reconstructive foot and ankle surgeon and past Clinical Instructor of Medicine at Emory, Dr. Pack practices at MCG 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. He also 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, March 27, 2009
Thursday, March 19, 2009
How valid is our medical data?
Ask the Doc……..
“How valid is the medical data we depend so much on?”
That’s a great question and one that many people fail to think about. Medical facts are like a container of milk; they have a shelf life. Just think about how much the thought process has changed since most of us have grown up. We were taught that if we wanted to be healthy we should have a good breakfast. That of course consisted of eggs, bacon, grits (of course if you were from the south), “Wonder Bread” (since it “built bodies 12 ways”) and perhaps some Hostess Twinkies and chocolate milk. Today we’re told that very same breakfast might cause us to die of a coronary before lunch!
Red wine is good. No it’s bad. No it’s good for us. Drink a gallon of water a day. No you don’t need nearly that much. Yes you do. No you don’t. The facts change every few years.
Most recently data has shown that the prostate screenings men have been constantly told “must be done” and is “life saving” actually have not been shown to save lives. That certainly doesn’t mean they aren’t important but it does cause one to wonder.
And even if you follow the trends, you can’t always depend upon the data. That’s because of the limited government funding for research that causes many researchers to look to drug companies for needed dollars. Such companies can very much alter the “facts” in many ways. This can include changing the definition of outcomes after the tests and having their own employees ghostwrite the actual studies.
Some very impressive, valid, new data has just come out regarding osteoarthritis that will completely change the thinking and treatment of this disease. Long thought to be primarily due to age and excessive weight, the latest data actually shows that abnormal alignment (like a longer leg or flattened foot) is the major cause of arthritis of our weight bearing joints (feet, ankles, knees, hips and back).
The prestigious Journal of the American Medical Association for example, has reported that “abnormal alignment of only five degrees (as measured from the ankle to the hip) increased the progression of osteoarthritis four to five times!”
Most recently the famed Mayo Clinic’s study showed that for “each degree of abnormal alignment there was a significant increased risk of the progression of arthritis of the knee,” and that “increasing age was only weakly associated with an increase risk of osteoarthritis of the knee.” They now consider poor alignment as “one of the most important risk factors for osteoarthritis.”
So the best way to stay active without pain, medications or surgery is to have a structural
evaluation and function with as little joint stress as possible.
We need data and must depend upon the latest research for our health. But like anything else, “let the buyer beware.”
A former reconstructive foot and ankle surgeon and past Clinical Instructor of Medicine at Emory, Dr. Pack practices at MCG 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. He also 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.
“How valid is the medical data we depend so much on?”
That’s a great question and one that many people fail to think about. Medical facts are like a container of milk; they have a shelf life. Just think about how much the thought process has changed since most of us have grown up. We were taught that if we wanted to be healthy we should have a good breakfast. That of course consisted of eggs, bacon, grits (of course if you were from the south), “Wonder Bread” (since it “built bodies 12 ways”) and perhaps some Hostess Twinkies and chocolate milk. Today we’re told that very same breakfast might cause us to die of a coronary before lunch!
Red wine is good. No it’s bad. No it’s good for us. Drink a gallon of water a day. No you don’t need nearly that much. Yes you do. No you don’t. The facts change every few years.
Most recently data has shown that the prostate screenings men have been constantly told “must be done” and is “life saving” actually have not been shown to save lives. That certainly doesn’t mean they aren’t important but it does cause one to wonder.
And even if you follow the trends, you can’t always depend upon the data. That’s because of the limited government funding for research that causes many researchers to look to drug companies for needed dollars. Such companies can very much alter the “facts” in many ways. This can include changing the definition of outcomes after the tests and having their own employees ghostwrite the actual studies.
Some very impressive, valid, new data has just come out regarding osteoarthritis that will completely change the thinking and treatment of this disease. Long thought to be primarily due to age and excessive weight, the latest data actually shows that abnormal alignment (like a longer leg or flattened foot) is the major cause of arthritis of our weight bearing joints (feet, ankles, knees, hips and back).
The prestigious Journal of the American Medical Association for example, has reported that “abnormal alignment of only five degrees (as measured from the ankle to the hip) increased the progression of osteoarthritis four to five times!”
Most recently the famed Mayo Clinic’s study showed that for “each degree of abnormal alignment there was a significant increased risk of the progression of arthritis of the knee,” and that “increasing age was only weakly associated with an increase risk of osteoarthritis of the knee.” They now consider poor alignment as “one of the most important risk factors for osteoarthritis.”
So the best way to stay active without pain, medications or surgery is to have a structural
evaluation and function with as little joint stress as possible.
We need data and must depend upon the latest research for our health. But like anything else, “let the buyer beware.”
A former reconstructive foot and ankle surgeon and past Clinical Instructor of Medicine at Emory, Dr. Pack practices at MCG 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. He also 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, March 12, 2009
Tripping
Ask the Doc…………..
“I’m 73 years old and just started tripping. Is this just part of aging?”
We’ve all tripped. But frequently doing this indicates a problem rather than a hap occurrence.
Less common, more serious causes involve problems like Parkinson’s disease, and strokes. Arthritis causes tripping by making it more difficult to lift your feet when walking. Heavy shoes with thick, ridged rubber soles can also be a cause, especially on carpet.
We assume we trip due to our age. But tripping is usually due to tight calf muscles that can cause you to fall or appear clumsy at any age; like children, whose parents tell them to “pick their feet up” when they walk.
Almost everyone will develop tight calf muscles. Simply walking causes these muscles to tighten and functionally shorten and it’s worse if we’re very active.
Picture a rubber band from the tips of your toes, going down the bottom of your foot, running up the back of your leg and attaching behind your knee. If that band is tight it will have a tendency to pull your foot downward and make it harder to pick your feet up when you walk. And that’s why most people trip!
Tight calf muscles can also cause pain in the fronts of the legs (shin splints) or stress fractures, bone spurs in the back of the heels, and ruptures of the Achilles tendon.
Take a look at the soles of your shoes, at the very ends where your toes would be. Wearing your shoes out in this area is a good clue that you have this problem.
Tight calves also affect sports. Tennis players will have a harder time on clay and runners will be slower on grass. Golfers will fatigue easier. Coaches and trainers often miss this condition as a major factor in decreased performance. Football players often suffer from this undetected problem than from dehydration.
Treatment consists of proper stretching exercises. Remember, the more active you are, the more you have to stretch. In severe cases a special trigger point injection can be given which is painless (really), often long lasting, and produces dramatic results. This can be quite affective even in elderly people.
So you may not be as clumsy as you think! And this may have nothing to do with your age. But if you continue to trip or have symptoms of a neurological disease, see your physician.
A former reconstructive foot and ankle surgeon and past Clinical Instructor of Medicine at Emory, Dr. Pack practices at MCG 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. He also 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.
“I’m 73 years old and just started tripping. Is this just part of aging?”
We’ve all tripped. But frequently doing this indicates a problem rather than a hap occurrence.
Less common, more serious causes involve problems like Parkinson’s disease, and strokes. Arthritis causes tripping by making it more difficult to lift your feet when walking. Heavy shoes with thick, ridged rubber soles can also be a cause, especially on carpet.
We assume we trip due to our age. But tripping is usually due to tight calf muscles that can cause you to fall or appear clumsy at any age; like children, whose parents tell them to “pick their feet up” when they walk.
Almost everyone will develop tight calf muscles. Simply walking causes these muscles to tighten and functionally shorten and it’s worse if we’re very active.
Picture a rubber band from the tips of your toes, going down the bottom of your foot, running up the back of your leg and attaching behind your knee. If that band is tight it will have a tendency to pull your foot downward and make it harder to pick your feet up when you walk. And that’s why most people trip!
Tight calf muscles can also cause pain in the fronts of the legs (shin splints) or stress fractures, bone spurs in the back of the heels, and ruptures of the Achilles tendon.
Take a look at the soles of your shoes, at the very ends where your toes would be. Wearing your shoes out in this area is a good clue that you have this problem.
Tight calves also affect sports. Tennis players will have a harder time on clay and runners will be slower on grass. Golfers will fatigue easier. Coaches and trainers often miss this condition as a major factor in decreased performance. Football players often suffer from this undetected problem than from dehydration.
Treatment consists of proper stretching exercises. Remember, the more active you are, the more you have to stretch. In severe cases a special trigger point injection can be given which is painless (really), often long lasting, and produces dramatic results. This can be quite affective even in elderly people.
So you may not be as clumsy as you think! And this may have nothing to do with your age. But if you continue to trip or have symptoms of a neurological disease, see your physician.
A former reconstructive foot and ankle surgeon and past Clinical Instructor of Medicine at Emory, Dr. Pack practices at MCG 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. He also 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, March 5, 2009
Choosing a Doctor
Choosing a Doctor
Ask the Doc……..
“What kind of doctor should I see for the pain in my right knee?”
If you had a problem with an old, valuable piece of furniture you would do well to take it to an antique furniture refinisher and not someone inexperienced. But we often don’t treat ourselves that way; and insurance companies love that. They often mandate that you to go to your general practitioner to keep their costs down.
Now don’t get me wrong, we need general practitioners, and more of them! And seeing these wonderful physicians first is often best. But when indicated, you should see a specialist simply because they will know more about your problem since that’s all they do.
That said, be careful. Think of today’s specialist as someone who knows more and more about less and less. They are often brilliant in their very narrow scope of expertise, but often know little outside of that particular area. So choosing the right doctor is important or you may end up being one of the “wandering wounded,” going from doctor to doctor seeking relief.
If your knee pain is due to an injury or overuse, see a good orthopedic surgeon; if possible, one that just does knees. But remember, orthopedists are surgeons. So if your knee pain is due to arthritis, a far better choice might be a rheumatologist.
Rheumatologists are board certified internists who have sub specialized in arthritic problems of the joints. So they are like “super” internists, not surgeons, and are experts on the best medications to take for arthritic problems. Physical therapists can also be helpful, but it’s best to find out what you’re treating first.
And if your knees hurt for any reason, see someone who specializes in structural analysis, because other specialists usually don’t evaluate or treat the abnormal structural components we all have, that can either cause or make your knee pain worse. And without fixing your “bent frame,” only part of the problem is being addressed.
Remember that none of us are built perfectly, and structural problems increase the wear and tear on our joints, in the same way that poor wheel alignment causes abnormal wear on our tires. For example, if you have a tendency to roll your foot in and flatten your arch (pronation), this will cause your knee to rotate inward, causing a great deal of stress on it. If you have a longer leg (and we all do to some extent), the stress on one of your knees is greatly increased.
Recent studies at the famed Mayo Clinic showed that even the smallest alignment problems can increase the stress on your knees significantly. As a matter of fact, structural problems are the major cause of arthritis in our weight bearing joints (feet, ankles, knees, hips and back). So by correcting these problems patients can often get significant relief.
A former reconstructive foot and ankle surgeon and past Clinical Instructor of Medicine at Emory, Dr. Pack practices at MCG 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. He also 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 kind of doctor should I see for the pain in my right knee?”
If you had a problem with an old, valuable piece of furniture you would do well to take it to an antique furniture refinisher and not someone inexperienced. But we often don’t treat ourselves that way; and insurance companies love that. They often mandate that you to go to your general practitioner to keep their costs down.
Now don’t get me wrong, we need general practitioners, and more of them! And seeing these wonderful physicians first is often best. But when indicated, you should see a specialist simply because they will know more about your problem since that’s all they do.
That said, be careful. Think of today’s specialist as someone who knows more and more about less and less. They are often brilliant in their very narrow scope of expertise, but often know little outside of that particular area. So choosing the right doctor is important or you may end up being one of the “wandering wounded,” going from doctor to doctor seeking relief.
If your knee pain is due to an injury or overuse, see a good orthopedic surgeon; if possible, one that just does knees. But remember, orthopedists are surgeons. So if your knee pain is due to arthritis, a far better choice might be a rheumatologist.
Rheumatologists are board certified internists who have sub specialized in arthritic problems of the joints. So they are like “super” internists, not surgeons, and are experts on the best medications to take for arthritic problems. Physical therapists can also be helpful, but it’s best to find out what you’re treating first.
And if your knees hurt for any reason, see someone who specializes in structural analysis, because other specialists usually don’t evaluate or treat the abnormal structural components we all have, that can either cause or make your knee pain worse. And without fixing your “bent frame,” only part of the problem is being addressed.
Remember that none of us are built perfectly, and structural problems increase the wear and tear on our joints, in the same way that poor wheel alignment causes abnormal wear on our tires. For example, if you have a tendency to roll your foot in and flatten your arch (pronation), this will cause your knee to rotate inward, causing a great deal of stress on it. If you have a longer leg (and we all do to some extent), the stress on one of your knees is greatly increased.
Recent studies at the famed Mayo Clinic showed that even the smallest alignment problems can increase the stress on your knees significantly. As a matter of fact, structural problems are the major cause of arthritis in our weight bearing joints (feet, ankles, knees, hips and back). So by correcting these problems patients can often get significant relief.
A former reconstructive foot and ankle surgeon and past Clinical Instructor of Medicine at Emory, Dr. Pack practices at MCG 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. He also 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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