Although certainly not on a par with cancer or heart disease, the importance of equalizing leg lengths is greatly underestimated, poorly evaluated, and if found, usually left uncorrected; especially if less than a quarter of an inch, which is considered normal.
But “normal,” means average. And the average person also has high cholesterol, weighs more, and is less active and more stressed than a healthy person should be. So I don’t think we really want to be average.
Unequal leg lengths can be due to structural or functional causes, and it’s important to differentiate these causes and treat them appropriately.
Now, after treating arthritic patients for over thirty five years, I’m still amazed at the powerful, positive impact of equalizing leg lengths. For example, when a patient with an arthritic hip or knee does a simple squat with the proper amount of correction under their short leg, often there is an immediate decrease in pain.
That’s because abnormal alignment causes excessive wear on the joints, which results in destructive arthritic changes and subsequent pain. A recent study showed that those with an above average leg length difference had almost twice the incidence of knee arthritis. But by equalizing leg lengths, arthritic patients can often be made to function on the part of their knee or hip joint that still has cartilage. This occurs in the same way that realigning the tires on your car enables you to ride on the tread that is still there, thus improving ride quality and extending the life or your tires.
Although often overlooked, it’s even more important after a knee or hip replacement because this type of surgery very often results in a leg length that is longer or shorter than it was before the joint was replaced! This causes additional stress on the new joint, as well as the other weight bearing joints of the feet, ankles, knees, hip and back.
Unequal leg lengths have the same powerful affect in sports. In golf for example, equalizing leg lengths can increase performance and decrease injuries.
So if you’re interested in preventative health, decreasing the stress on your weight bearing joints, or improving sports performance, equalize your leg lengths. Sometimes it’s as simple as putting a lift in your shoe on the shorter side!
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, April 30, 2009
Thursday, April 16, 2009
Is Arthritis Medication Safe?
Osteoarthritis, has reached epidemic proportions. One in every two seniors is now at risk of developing arthritis of their knees. Last year there were over half a million knee and hip replacements.
Since it’s generally believed that there is no known cause or cure (other than age and excessive weight), a physicians goal is to keep you pain free and active as long as they can. And while it’s wonderful that we have medications, remember that pain is something we’re designed to have as it warns us that if we keep doing the activity that caused it, not only will the pain worsen, but so will the damage.
In pharmacy school I learned one lesson above all else; the less medication you take the better! Remember that anything you put into your body that isn’t supposed to be there has risks. And even if the risks are one in a thousand, they’re 100% if they happen to you!
If prescription drugs were as safe as we’re often led to believe, we wouldn’t need a signed document (prescription) that only a licensed physician can write, to purchase them. If you read the precautionary information about these drugs you would be much more reluctant to take them. But serious complications can occur with non-prescription medications too, and this is validated by an overwhelming amount of studies.
Despite this, there are over 13 million Americans taking anti-inflammatory drugs like Advil, Motrin and Aleve, that results in 16,500 deaths each year! In some cases, drugs like Vioxx and Celebrex have also been shown to actually make your arthritis worse! And unfortunately, you can’t always depend upon the validity of research studies, many of which are sponsored by the drug companies who make and sell these drugs.
Despite the commonly accepted theories that osteoarthritis has no known cause or cure, it does. Abnormal friction and pressure wears away joints in the same way that poorly aligned tires wear abnormally and prematurely. You don’t simply get pain in your knee or hip because you reached a certain age. And the latest research now confirms this.
Sometimes drugs are needed and necessary but having yourself structurally evaluated to eliminate simple things like a longer leg or flattened foot can go a long way in saving your joints and helping you avoid drugs that can indeed have serious implications.
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.
Since it’s generally believed that there is no known cause or cure (other than age and excessive weight), a physicians goal is to keep you pain free and active as long as they can. And while it’s wonderful that we have medications, remember that pain is something we’re designed to have as it warns us that if we keep doing the activity that caused it, not only will the pain worsen, but so will the damage.
In pharmacy school I learned one lesson above all else; the less medication you take the better! Remember that anything you put into your body that isn’t supposed to be there has risks. And even if the risks are one in a thousand, they’re 100% if they happen to you!
If prescription drugs were as safe as we’re often led to believe, we wouldn’t need a signed document (prescription) that only a licensed physician can write, to purchase them. If you read the precautionary information about these drugs you would be much more reluctant to take them. But serious complications can occur with non-prescription medications too, and this is validated by an overwhelming amount of studies.
Despite this, there are over 13 million Americans taking anti-inflammatory drugs like Advil, Motrin and Aleve, that results in 16,500 deaths each year! In some cases, drugs like Vioxx and Celebrex have also been shown to actually make your arthritis worse! And unfortunately, you can’t always depend upon the validity of research studies, many of which are sponsored by the drug companies who make and sell these drugs.
Despite the commonly accepted theories that osteoarthritis has no known cause or cure, it does. Abnormal friction and pressure wears away joints in the same way that poorly aligned tires wear abnormally and prematurely. You don’t simply get pain in your knee or hip because you reached a certain age. And the latest research now confirms this.
Sometimes drugs are needed and necessary but having yourself structurally evaluated to eliminate simple things like a longer leg or flattened foot can go a long way in saving your joints and helping you avoid drugs that can indeed have serious implications.
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.
Thursday, April 9, 2009
Latest research on the Real Cause of Arthritis
Like most physicians I was taught that osteoarthritis was due to ageing; like gray hair and wrinkles. But the fact that it primarily occurs when we’re older doesn’t necessarily mean it’s due to age. There is a difference between a correlation and a cause. Arthritis, like heart disease, takes a long time to develop, but age is not the cause.
My work over forty years in this area has shown that contrary to what is currently believed, that abnormal structure wears out our joints in the same way that poorly aligned tires wear out sooner. Now more and more credible data is substantiating my premise.
A recently published arthritis textbook of the latest research was reviewed by Dr. Hunter, a preeminent rheumatologist. He states that arthritis should now be viewed as being “primarily due to mechanical factors” and that by physicians “focusing more on this, we have the opportunity to help millions of patients with arthritis.”
Dr. Jason Theodosakis is considered one of the foremost authorities in the world on osteoarthritis. In his book, The Arthritis Cure,” he continually emphasizes the important role that abnormal function plays in osteoarthritis. He states that, “it is critically important to control how we walk and function if we really want to treat arthritis.”
In 2001, the prestigious Journal of the American Medical Association 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 53% 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.”
We are not born perfect. Any degree of abnormality (like a flattened foot or longer leg) increases joint friction and over time causes arthritis.
The best way to prevent arthritis of the weight bearing joints of our feet, ankles, knees, hips and neck is to be structurally evaluated and fix (on a permanent basis) the problems found. Optimizing how we function, especially after knee or hip joint replacement, is critical to staying active without pain as we age.
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.
My work over forty years in this area has shown that contrary to what is currently believed, that abnormal structure wears out our joints in the same way that poorly aligned tires wear out sooner. Now more and more credible data is substantiating my premise.
A recently published arthritis textbook of the latest research was reviewed by Dr. Hunter, a preeminent rheumatologist. He states that arthritis should now be viewed as being “primarily due to mechanical factors” and that by physicians “focusing more on this, we have the opportunity to help millions of patients with arthritis.”
Dr. Jason Theodosakis is considered one of the foremost authorities in the world on osteoarthritis. In his book, The Arthritis Cure,” he continually emphasizes the important role that abnormal function plays in osteoarthritis. He states that, “it is critically important to control how we walk and function if we really want to treat arthritis.”
In 2001, the prestigious Journal of the American Medical Association 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 53% 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.”
We are not born perfect. Any degree of abnormality (like a flattened foot or longer leg) increases joint friction and over time causes arthritis.
The best way to prevent arthritis of the weight bearing joints of our feet, ankles, knees, hips and neck is to be structurally evaluated and fix (on a permanent basis) the problems found. Optimizing how we function, especially after knee or hip joint replacement, is critical to staying active without pain as we age.
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, April 2, 2009
Will Technology Make the Difference In the Masters?
Certainly, technology is important in golf. Better clubs and balls have forced designers to make longer and more difficult courses. But despite the accepted thinking, technology is not as important as we are led to believe. In fact, according to the USGA the average handicap has decreased less than one half of one stroke in the last ten years!
If technology was the answer, than why do so many of the top pros (highly endorsed by the best companies with the greatest and latest equipment), choose basic irons instead of racket sized titanium heads and state of the art carbon graphite shafts, while others simply throw their balls on the grass instead of using the latest tees (that are supposed to decrease ball resistance)?
The most important thing in performing well is not technology but talent; knowing exactly how to hit the ball and how to consistently execute the ideal swing best suited to each individual.
Secondly, and critically important, yet almost always overlooked, is structure. No one is born structurally perfect and any degree of abnormality (such as a longer leg or flattened foot) decreases performance, increases the risks of injury, and can later cause arthritic changes.
For example, no one has equal leg lengths, so every golfer is playing out of balance to some degree. A right handed golfer with a long left leg will always find it more difficult to follow through on their swing because in essence they are swinging up hill.
Great athletes have learned to compensate for their structural problems. Arnold Palmer has always had great difficulty completing his swing. Sure, he was great anyway. But how much better could he have been if didn’t always have this problem?
Players like Vijay Singh, Phil Michelson, and Davis Love III, have significant structural issues that put them at a major disadvantage with each and every shot they take. And no piece of technologically advanced equipment can fully compensate for this.
There are many reasons for a sudden decrease in performance, and it’s not always because an athlete “chokes”. Some of the most common relate to structural abnormalities. These problems decrease performance from the onset but take far greater tolls with time.
A few years ago (at the Masters), Rocco Mediate played well for days before completely falling apart. I believe his tight calf muscles cost him the Masters. In 2007, Brett Wetterich played great and then he too fell apart. Brett has significant structural issues as well. You could see his foot flatten (collapse) with each step he took.
Simply watch the way these players walk and stand and compare them to the likes of Tiger Woods and Gary Player, and you will notice a remarkable difference. Tiger is as close to being structurally ideal as any golfer I have ever seen. When you see the incredible turning radius in his swing, remember that to a large extent that is based on the equalization of his leg lengths, which enable him to have a better positioned vertical axis. And I don’t believe Gary Player’s longevity and vitality would be possible without the sound footing his well aligned structure permits. The same is true of Nolan Ryan and all great athletes with long careers.
Technology can and does help. But even the best Ferrari's in the world will not run as fast without wheels and tires that aren’t ideally aligned and balanced!
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.
If technology was the answer, than why do so many of the top pros (highly endorsed by the best companies with the greatest and latest equipment), choose basic irons instead of racket sized titanium heads and state of the art carbon graphite shafts, while others simply throw their balls on the grass instead of using the latest tees (that are supposed to decrease ball resistance)?
The most important thing in performing well is not technology but talent; knowing exactly how to hit the ball and how to consistently execute the ideal swing best suited to each individual.
Secondly, and critically important, yet almost always overlooked, is structure. No one is born structurally perfect and any degree of abnormality (such as a longer leg or flattened foot) decreases performance, increases the risks of injury, and can later cause arthritic changes.
For example, no one has equal leg lengths, so every golfer is playing out of balance to some degree. A right handed golfer with a long left leg will always find it more difficult to follow through on their swing because in essence they are swinging up hill.
Great athletes have learned to compensate for their structural problems. Arnold Palmer has always had great difficulty completing his swing. Sure, he was great anyway. But how much better could he have been if didn’t always have this problem?
Players like Vijay Singh, Phil Michelson, and Davis Love III, have significant structural issues that put them at a major disadvantage with each and every shot they take. And no piece of technologically advanced equipment can fully compensate for this.
There are many reasons for a sudden decrease in performance, and it’s not always because an athlete “chokes”. Some of the most common relate to structural abnormalities. These problems decrease performance from the onset but take far greater tolls with time.
A few years ago (at the Masters), Rocco Mediate played well for days before completely falling apart. I believe his tight calf muscles cost him the Masters. In 2007, Brett Wetterich played great and then he too fell apart. Brett has significant structural issues as well. You could see his foot flatten (collapse) with each step he took.
Simply watch the way these players walk and stand and compare them to the likes of Tiger Woods and Gary Player, and you will notice a remarkable difference. Tiger is as close to being structurally ideal as any golfer I have ever seen. When you see the incredible turning radius in his swing, remember that to a large extent that is based on the equalization of his leg lengths, which enable him to have a better positioned vertical axis. And I don’t believe Gary Player’s longevity and vitality would be possible without the sound footing his well aligned structure permits. The same is true of Nolan Ryan and all great athletes with long careers.
Technology can and does help. But even the best Ferrari's in the world will not run as fast without wheels and tires that aren’t ideally aligned and balanced!
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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