Tuesday, July 30, 2013

REPOST: For U.S. retirees, fitness lessons from Japan

One might expect a direct correlation between competent health services and prolonged life span of the people. However, it seems some countries, like the United States, still do not experience the latter even after investing in better health care services. This Market Watch article discusses some ways the U.S. can learn from Japan when it comes to expanding the life expectancy of its citizens. 

She wore a dark hat even though the sun had gone down, as she swung alone on a swing-set in Tokyo. Unsupervised children aren’t an uncommon sight on Japanese playgrounds, but it was dinnertime. And the hat looked more middle-aged gardener than little girl. Curiosity piqued, I approached the petite swinger. She turned out to be a septuagenarian.

I saw older exercisers everywhere on a recent trip to Japan: Stretching on jungle gyms, walking briskly in pairs, gathering in groups to do calisthenics broadcast over the radio. All this movement no doubt contributes to Japan’s vaunted longevity. The Pacific nation not only leads the developed world in absolute longevity, with a life expectancy of 82.6 for men and women combined, but it is also first in what researchers call healthy life expectancy. That is the number of years that a person can expect to live in good health, and for Japan it is 73.0, versus 68.1 for the U.S., according to a study released last week in the Journal of the American Medical Association. (Our healthy life expectancy ranked 26th out of 34 advanced-economy countries in the study.)

The study, a collaboration of researchers at multiple institutions, found that while the U.S. made “substantial progress” in improving health from 1990 to 2010, we lag many other high-income countries on life expectancy and other measures despite spending more on health care than they do—both as a society, and out of our own pockets. When it comes to preventing disease and disability, many experts say physical activity trumps all other healthy behaviors. “Exercise for aging is truly the fountain of youth,” said Paula Papanek, program director of the exercise science degree program at Marquette University in Milwaukee.

The benefits of exercise, of course, can also have significant financial repercussions, especially for people 50 and over. It is a simple fact that unhealthy people spend more on medical care than their more robust counterparts. In just one example, Medicare is likely to spend about $38,000 more over the lifetime of an obese 70-year-old than it would spend on a beneficiary of similar age and normal weight, according to research led by Dana Goldman of the Schaeffer Center for Health Policy and Economics at the University of Southern California. And that is just Uncle Sam’s share: it follows that an obese person would incur more out-of-pocket costs than her thinner peers, as well.

Regular exercise won’t likely prolong your life dramatically, but it can improve the quality of your remaining years, said Dr. Edward Schneider, professor of gerontology and medicine at the University of Southern California. Ideally, exercise begun no later than middle age can help people avoid developing conditions like diabetes and heart disease. But physical exertion can also help people manage many chronic conditions after they develop. It can reduce chronic knee and back pain. Regular physical activity also improves sleep and helps prevent falls. And it isn’t just the body that benefits: Research suggests exercise can also ease depression and, in older adults, boost brain function.

In fact, regular exercise can mean the difference between independent living and costly institutionalization for older people, experts say. Schneider saw evidence of this in his own family. At age 89, his very active grandmother was a nursing home volunteer; by the time she reached the same age, his more sedentary mother was a nursing-home resident. The median national rate for a private room in a nursing home is $83,950 annually, according to the 2013 Genworth Cost of Care Survey (although cost, of course, isn’t the only reason most people would prefer to age in their own homes).

Even the frailest older people can benefit from moving to the extent they’re able, said Michael R. Mantell, senior fitness consultant for behavioral sciences for the American Council on Exercise. His wife Paula, a certified personal trainer, has among her clients a couple in their 80s. The wife is wheelchair-bound and has Alzheimer’s disease, but she delights in playing catch and other games with Paula, and she’s improving her strength, balance and coordination by doing so, Mantell said.

Exercise benefits everyone, including the svelte. Being thin doesn’t give you a free pass to couch surf. People who are healthy but sedentary lose 10% to 15% of their aerobic capacity and muscle strength per decade starting around age 35, said Dr. Michael Joyner, an exercise researcher at the Mayo Clinic in Rochester, Minn. People who maintain a healthy weight and exercise 150 minutes per week can delay the start of the loss by five to 10 years and reduce the rate of loss, he said. This advantage can translate into stronger bones and fewer falls down the line.

No serious sweat required
When we talk about exercise, we don’t necessarily mean sweating it out at the gym. Brisk walking outside—or in a mall, if the weather’s bad—works just fine. The key, Schneider said, is to keep it fun and interesting. Record your favorite show and watch it on the treadmill, or buy a dance DVD and boogie down in your living room. Find a buddy to attend exercise classes with you.

You don’t need to break a serious sweat, either. Experts recommend “moderate” exercise, and on a scale of 1 to 10, with 1 sitting on the couch and watching TV, and 10 running so hard you can’t talk, moderate exercise would be a 5 or a 6, Mantell said—the equivalent of walking when you’re in a hurry. Older exercisers should combine aerobic exercise around five times a week with strength training at least two times a week and regular balance training, experts recommend. While balance training can take the form of tai chi or yoga, it could also simply mean standing on one foot while waiting in line at the store (as long as there is ready support nearby).

It is wise to consult your doctor before beginning any exercise program. While almost everyone can benefit from movement, physical activity can be dangerous for someone with undiagnosed heart disease, for example. Prospective exercisers can find a questionnaire online (http://www.recgov.org/fitness/PAR-Q.pdf) called PAR-Q, short for “physical activity readiness questionnaire,” that can flag potential concerns to bring to a doctor. If heart disease is diagnosed, a patient might be assigned to supervised exercise until he’s ready to exercise on his own, Papanek said. Diseases aside, many older Americans wind up in the emergency room with exercise-related injuries after taking on too much, too soon, Schneider said. Those starting out would benefit from a session with a personal trainer, he noted.

If this all sounds daunting, consider this: The biggest benefits of exercise accrue not to the regular runner who doubles her distance from five to 10 miles, but to the sedentary person who decides to get off the couch. Said Joyner, “You get a lot of the benefit with the first bit of effort.” Even just the effort it takes to put in a few minutes on a swing set. 

Norman K. Poppen, MD , is a bone doctor who provides expert recommendations to patients regarding the kinds of exercise they can do to strengthen their bodies. More information is available at this website.

Monday, April 29, 2013

Fitness trends: What CrossFit can do for back strength

CrossFit is a fitness company which offers a program of the same name that is practiced in over 4,400 gyms worldwide. CrossFit’s strength and conditioning programs combine constantly varied functional movements in a timed and scored workout. A “functional movement” is defined as a motion or position which is naturally occurring– performed almost instinctively as part of everyday life and activity. CrossFit exercises focus on the body’s core muscles but are never the same each day. By varying the workout daily, CrossFit programs aim to improve a person’s ability to adapt to fast-changing environments. This also trains all muscles in the body, instead of “spot training” specific muscles as body-building programs do.


Image Source: youtube.com

Each Workout of the Day (or WOD, in CrossFit jargon) improves a total of 10 fitness skills: cardiovascular endurance, respiratory function, strength, flexibility, agility, power, speed, coordination, balance, and accuracy. In addition to being essential for playing all sports, these skills are also applicable to daily movement. Workout intensity level depends entirely on the person performing the exercise, which is why CrossFit WODs can be performed by individuals of any age, weight, athletic ability, and fitness level.

Image Source: crossfit.com

Because CrossFit workouts focus on strengthening the core, they are advisable for people with weak back muscles. WODs can also prevent back injury, as CrossFit teaches practitioners how to maintain the correct poses when lifting heavy objects or picking things up from the floor. Some back-strengthening exercises include using a kettlebell, a tool that orthopedic surgeons like Norman K. Poppen, M.D., recommend for strength training.

Image Source: telegraph.co.uk

This website lists more physician-suggested exercises and stretches for improving back strength.

Monday, March 25, 2013

How ill-fitting shoes can harm the body


Image Source: ripleys.com 


Making up almost 25 percent of the body’s bone structure, the feet are the foundation that lets people stand, walk, and run. In addition to holding the weight of the entire body, the feet hold a connection to total body wellness so they need the right cushion to function well.


In this fast-paced and proactive culture, wearing comfortable footwear is by far one of the best things to do to take care of the feet. However, many can’t resist the allure of pointed stilettos, elevator shoes, or a trendy 5-inch platform, that they tend to sacrifice comfort for the sake of style.




Image Source: ehow.com 


The habit of wearing the wrong shoes has repercussions, and some of them take time to develop. Wearing uncomfortable shoes can cause any of the bones in the feet to misalign, disrupting the transfer of signals from the foot to the central nervous system, and vice versa. This factor may explain how foot problems can cause other problems like fatigue and physiological changes.


 Another reason is that shoes tend to upset the body’s center of balance, leading to spine problems, migraines, joint degeneration, and knee osteoarthritis. Strutting in heels also puts the person at risk of developing shorter calf muscles, thicker Achilles tendons, foot deformities, ankle sprains, bunions, and fractures.




Image Source: indiacurrentaffairs.org 


But wearing flat shoes isn’t the solution. Flat shoes without arch support aren’t enough to absorb the pressure of the feet hitting the ground. This pressure gradually results to pain that climbs up from the arch of the foot up to the hip.


The best way to break the bad footwear routine is to wear such kinds of shoes in moderation. There are limits to what the feet can take, and giving them a rest from 5-inch heels can go a long way.  


Orthopedic surgeons like Norman K. Poppen, MD, advise people to choose footwear that provides the needed support and comfort. Learn more about bone health on this blog.

Thursday, January 24, 2013

Buckle and stress: The different types of fracture


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Most people assume that a bone “fracture” is an injury less severe than a bone “break.” In fact, bone “breaks” and “fractures” are one and the same. The term “break” or “broken” is simply not an orthopedically accepted for describing damage to bones. Bone fractures are not limited to people with active lifestyles– even celebrities break their bones.


A bone can be fractured in several ways. Determining what kind of fracture has occurred helps set the bone for recovery. In diagnosing a fractured bone, doctors first check if the fracture is simple or compound. A simple fracture, also known as a closed fracture, is a bone fracture where the skin remains intact. Although simple fractures cause severe pain, they are sometimes mistaken for other types of injury because the broken bone remains concealed. When the broken bone penetrates the skin, it is a compound or open fracture. Open fractures put a patient at a higher risk of infection.



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Whether simple or compound, fractures are further classified into types. These are the most common:


• A greenstick fracture is an incomplete fracture. The bone is bent rather than broken off. This is most common among children as their bones are strong yet flexible. An adult would likely have more brittle bones which would snap instead of bend.


• A transverse fracture is a fracture that puts a bone at a right angle to its axis.


• A comminuted fracture is when the fractured bone fragments into several pieces. An open comminuted fracture is slightly more dangerous than other types of breaks as scattered fragments take longer to heal and, as such, are exposed to the risk of infection for a longer time.



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Bone fractures should not be taken lightly. Leaving a fractured bone untreated can result in myriad complications, including infection and paralysis.




Recommendations for exercises and stretches to strengthen bones come from expert like Norman K. Poppen, M.D.  Visit this website for such details.

Friday, December 21, 2012

Avoiding arm casts this winter

Image Credit: geniusbeauty.com


Many cases of injury originate from attempts to have fun. In winter, many people seek to take full advantage of the holidays and the snow, and engage in activities that sometimes leave them with several broken bones. If wearing an arm cast is not your idea of celebrating the Yuletide season, try these tips.


Warm up

Cold temperatures can leave the muscles in a state that is more prone to injury. It is best to take a few warm-up exercises especially if you are engaging in strenuous activities. For instance, you can take a few warm-up runs before skiing in new terrains.


Image Credit: runnersvoice.org


Know the terrain

Keep track of rocks, roots, fences, ridges, and others. Knowing where obstacles are can help you avoid them and the possibility of being injured because of them. Moreover, navigating through snowy ground poses certain difficulties; it is best for you to stay in marked trails. Ice is slippery, so staying in areas such as steep slopes and inclines is the beginning of injury.


Be properly equipped

Make sure to wear the proper equipment or attire. When walking in snowy or icy ground, use shoes with lots of tread as these offer more grip and minimizes the risk of slips. Wear several layers of loose garments. This can protect you from the cold and offers you the convenience of removing or adding layers depending on the need.


Image Credit: ahikingblog.com

You gain nothing from being overly complacent in winter—except scratches and broken bones. Doctors can treat fractures, but no one can return the winter holidays you lost because of broken limbs.

Norman K. Poppen, MD, is a recognized expert in the surgical treatment of musculoskeletal problems. Visit this Facebook page to learn more about him.

Thursday, November 22, 2012

Obama's Thanksgiving message

"Fight the overwhelming urge to take a nap...at least until AFTER dinner," and other pieces of Thanksgiving advice from President Obama. 


Monday, November 12, 2012

Soft but tough: Norman K. Poppen, MD, and the body's cartilage

The cartilage is not as tough as the bone, but it is no softie either. Orthopedist Norman K. Poppen, MD, is familiar with the cartilage and how it allows the entire skeletal system to perform some of its most important functions.

Norman K. Poppen. Image credit: altunderground.com

The cartilage is a connective tissue found in many areas in the human body, particularly in joints, in the rib cage, the ears, nose, ankle, knees, bronchial tubes, and in the intervertebral discs. It is quite common among other animals, particularly in cartilaginous fishes like sharks, rays, and sawfishes. It is naturally flexible, but is stiffer than muscles, and is not as rigid as bones.

Norman K. Poppen. Image credit: diabeteshypertension.com

The primary function of the cartilage is to provide support to various organs of the body without being as hard as bones. Experts like Norman K. Poppen, MD, note that the relative softness of the cartilage makes it an excellent cushion for bone joints. This means that the tissue plays a vital role in the smooth movement of the human body.

Norman K. Poppen. Image credit: health.rush.edu

Among connective tissues, the cartilage is the slowest to grow and be repaired. Needless to say, damage or complications can lead to serious problems. The gradual thinning of the cartilage can cause joint pains when moving, and is the underlying cause of arthritis. In the case of chondrodystrophies, the cartilage in the joints is ossified and is transformed into bone, causing symptoms roughly similar to those in arthritis.

Every component of a bodily system performs a specific function vital to the whole. The same is true for the cartilage. It may not be as tough as bones, but without it, the skeletal system would never be the same.

More information about Norman K. Poppen, MD, is available in this Facebook page.