Louis XIV, King of France, donned high heels in the late 16th century as did many men and women in aristocracy as a status symbol. But, these high status shoes were never meant to be comfortable to walk in because only the peasants walked. The wealthy took carriages. I am afraid not much has changed in shoe design and comfort in the last 400 years because high heels continue to be uncomfortable. Today, women have suffered great physical pain to continue this fashion trend popularized by every Playboy model and Miss America swimsuit contestant. High Heels – Look Like Heaven But Feel Like Hell! Recent research supports the fact that these fashion stilts are unhealthy. To the makers of Ferragamos, Maglis, and Louboutins, mea culpa!
The fact that I am vertically challenged has in no way influenced my opinion about the material presented in this column. In fact, whether my wife wears high heels or flats, she still must duck to avoid decapitation when we swing dance.
It turns out that several studies clearly demonstrate that the higher the height of the heel, the more likely one will develop osteoarthritis in the knee and stress on the lower back, among other health problems. Researchers at Harvard University studied women wearing heels 2.7 inches high. Two groups, both wearing 2.7 inch high heels, were studied to determine if heel width would influence joint stress. One group wore heels ½ inch wide and another wore heels 1.75 inches wide. Both groups displayed significant torque stresses on the joints of the lower body, specifically the knee and lower back. Furthermore, a 3 inch heel height was determined to place 7 times the force on the joints than a 1 inch heel. Researchers concluded that low-heeled shoes or no-heeled shoes (less than 1.5 inches) were the best choice to prevent health problems such as osteoarthritis of the knee and lower back. Moreover, flat shoes were not found to be ideal. The ideal shoe has a low heel (½ to ¾ inches) to distribute forces equally from the back to the front of the foot and knee. Also, it was concluded that a square-toed shoe with a roomy toe box can also prevent many foot and toe deformities and problems.
High heels shift the center of gravity forward and force the lower back to sway backwards to overcompensate. The shoe is the only contact between your foot (and the entire body) and the ground. Therefore, if the point of contact (foundation) is shifted off center or is unstable, then the entire body will compensate in its struggle for stability. An excessive sway back will cause torque and shifting of the vertebrae, unevenly compress and wear down the discs of the spine, and lead to degeneration and arthritis.
As found in the Harvard study, high heels lead to changes in gait patterns that cause excessive torque in the joints of the lower extremity, such as the hip and knee. This torque over time leads to wear and tear and arthritis.
When you where heels and your weight is shifted to the balls of your feet, excessive force and friction can cause blisters, corns and calluses.
The shift of weight forward when wearing heels can also inflame the nerves in the ball of your foot or toes and cause a neuritis called metatarsalgia or neuroma. Symptoms include sharp pain, tingling, or numbness.
High heels create andunstable platform for gait and can lead to poor balance. Moreover, this instability, worsened by a narrow or spiked high-heel, can lead to rolling the ankle and spraining the ankle.
Walking in high heels puts the calf muscle and its achillies tendon in a shortened position. Over time, this can lead to a permanent shortenening of the tendon that makes walking in bare feet or flat shoes uncomfortable.
Pump bump is also called “Hagland’s Deformity,” and is associated with wearing high heels that cause excessive pressure on the back of the heel bone which creates a bump on the bone. Hammertoe, a deformity that causes the toes to look like a hammer, is caused by a narrow, pointed shoe that forces the toes to curl. A narrow shoe can also cause a drift deformity of the big toe, also called “Hallux Valgus.” Both deformities are associated with arthritic changes and pain in the joints over time.
**SOURCE: Lower Extremity Review, www.ynhh.org/healthlink
Read “Health & Exercise Forum” – Every Monday. This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an affiliate faculty member at the University of Scranton, PT Dept.
Guest Columnist: Janet M. Caputo, PT, OCS
Last week this column discussed “The Top Ten Tips for Better Sleep.” One tip, relaxation, visualization and breathing techniques has great value as a natural sleep aid and warrants further discussion. Dozens of scientific studies have proven that relaxation is an effective treatment for insomnia. Relaxation techniques practiced during the day can counter daily stress responses and reduce the likelihood that stress hormones will be elevated at night. Since relaxation techniques elicit a brain-wave pattern similar to Stage I sleep, the transition state between waking and sleeping, they make it easier to eventually move into deeper sleep stages. When practiced at bedtime or after a nighttime awakening, relaxation techniques help turn off negative sleep thoughts, quiet the mind, and relax the body.
The key to relaxation is becoming aware of tension and its corresponding state, relaxation, in each of the body’s muscles. Once aware of the difference, you can learn to relax muscles one at a time until gradually your whole body is ready to drift into a restful sleep. Lying down or sitting comfortably, begin with the muscles in your feet. Contract the muscles with gentle force for three to five seconds and then relax. Don’t stop breathing while you tense the muscles. Repeat a few times and continue upwards to your calves, thighs, buttocks, and abdomen. Then, move onto your fingers, arms, neck, and face. Repeat this exercise two more times for a total of about forty-five minutes of relaxation time. Each time, you begin by tensing the muscles, holding the tension, and then relaxing.
Directing your attention from everyday problems by using a mental focusing device can help promote relaxation. You can choose a word or phrase that has special meaning to you, for example, sunset and repeat it, silently or out loud, until you feel relaxed. You can also choose a visual image of an enjoyable, relaxing place for example, walking on the beach. While you are in your favorite, peaceful place, imagine what you may be seeing, hearing, feeling, and smelling. When using your mental focusing device, let relaxation happen at its own pace. If distracting thoughts occur, disregard them and return your attention to your mental focusing device.
Diaphragmatic breathing can also promote relaxation using deep breathing techniques because it uses less effort and energy to breathe. When relaxed or sleeping, we breathe with the abdomen. When we feel stressed, our breathing pattern changes to short, shallow, irregular chest breaths, or we hold our breath. This type of breathing is not effective and further stresses the body. Since waste products were not removed during exhalation, they build up in the bloodstream and we feel more anxious. Practice the following steps to learn diaphragmatic breathing:
Breathing exercises that utilize diaphragmatic breathing can calm our bodies and promote sleep. The following are two examples of breathing exercises that are recommended to bring on drowsiness and reduce insomnia:
People who practice relaxation techniques fall back to sleep faster, sleep longer, have a better quality of sleep, and are more rested in the morning. Gradually they develop a greater sense of control over their mind and sleep. Although relaxation by itself is not a cure for insomnia, it has a significant positive effect on sleep for most insomniacs, especially when used in combination with the other tips discussed in last week’s column, which outlined 10 tips for better sleep.
Janet M. Caputo, PT, OCS, is clinic director at Mackarey & Mackarey Physical Therapy Consultants, LLC in Scranton, PA where she specializes in orthopedic, sports, and neurological physical therapy. She is a doctor of physical therapy student at the University of Scranton.
This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an affiliated faculty member at the University of Scranton, PT Dept.
Recently, I received an email from a reader who asked me if I thought sleep has a significant impact on health and wellness. The short answer is yes. The long answer is in this column…sleep is third only to diet and exercise when it comes to health and wellness. Gregory Cali, DO, Pulmonologist and Medical Director of The Sleep Disorder Center in Dunmore, PA., recommends that people discuss their sleep problems with their family physician because many medical conditions such as sleep apnea, narcolepsy, restless leg syndrome and others may contribute to sleep disorders.
The “24/7” society offers 24 hour cable, internet, email, and work shifts. According to the National Sleep Foundation, 20% of all Americans report less than 6 hours of sleep per night. Sleep deprivation contributes to poor work performance, athletic performance, motor vehicle accidents, relationship problems, mood swings, anger and depression. It is also associated with increased risk of heart disease, diabetes and obesity. However, all is not lost. Current wisdom offers the following suggestions to improve your chances for a good night’s sleep.
SOURCES: Stephanie Schorow, Lifescript; National Sleep Foundation; Gregory Cali, DO, Pulmonologist and Medical Director of The Sleep Disorder Center in Dunmore, PA.
Read more about relaxation tips for better sleep.
This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an affiliated faculty member at the University of Scranton, PT Dept.
How many times have you heard the phrase “My back is killing me!” Almost every American has had an episode of back pain themselves, or knows someone who has had significant back pain. Acute low back pain (LBP) is one of the most common health maladies in the United States and is the leading cause of disability in people younger than 45 years old. It is responsible billions of dollars in health care costs, and is a leading cause of missed work.
One of the most common questions that people ask is “Do I need to get an MRI if I have back pain?” In view of this, I have asked Jamie S. Stallman, MD, to address the indications for MRI testing for LBP. Dr. Stallman is a radiologist with Radiological Consultants, Inc. He practices at Advanced Imaging Specialists in Dunmore, Northeast Pennsylvania Imaging Center in Scranton, and at Moses Taylor Hospital.
LBP is divided into two very different categories. The first is uncomplicated LBP, and the second is complicated LBP. When pain is localized to the lower back (lumbar) region and there are no complicating factors, this is considered “uncomplicated” and no medical imaging is required. Uncomplicated LBP is usually a self-limiting condition, meaning that it goes away by itself without any treatment. Most people with this condition will experience relief of symptoms within a month and can resume normal activities without difficulty. Treatment for uncomplicated LBP is usually limited to over-the-counter medication, rest, and physical therapy. Imaging is not usually performed because the cause of the pain is related to muscles or connective tissue around the spine in the majority of cases.
In contrast, complicated LBP requires additional investigation by your health care provider. There are a few key features of complicated LBP that are important to remember. When any of these factors are present, it is possible that there may be a specific cause of the pain, such as a disc herniation, fracture, soft tissue lesion, spinal stenosis, or infection. The following is a list of “Red Flags” that puts back pain into the “complicated” category:
If any of these conditions apply to a patient with back pain, then a medical professional must be consulted. In most of these cases, the health care provider will order some type of imaging to try to identify the cause of the pain. An MRI is the most common test ordered to evaluate back pain but there are three other imaging modalities also used.
Magnetic Resonance Imaging is the best, and most commonly used imaging modality for spine problems. The MRI scanner utilizes strong magnets and radio waves to create images of the spine and surrounding anatomy. MRI provides the best pictures of disc hernations, ligaments, connective tissues, and nerves in the spine due to its superior pictures of soft tissues.
These are pictures produced by passing x-ray beams through the area of interest. X-rays mostly depict abnormalities that occur with bony structures such as fractures, listheses (or “slippage”), and disc spaces.
This test produces images from a radioactive chemical that is injected into a patient’s vein. Bone scans are very sensitive for detected bone abnormalities including fractures. Bone scans also have the ability to image the entire skeleton all at once.
CT, or Computed Tomography is commonly referred to as a “CAT” scan. Images are produced when a patient is placed lying down into the scanner (shaped like doughnut) where an x-ray tube rotates around in a circle. A computer then reconstructs highly detailed images of the bones and soft tissues of the spine.
A patient with complicated low back pain will be examined by a health care professional who will usually recommend that one or more of the above imaging modalities be considered. These tests are performed at most hospitals and outpatient imaging centers. The actual pictures are taken by a trained technologist. The radiologist,who is a physician specially trained in medical imaging, will then interpret the images and consult with the referring health care provider. Based on the imaging findings and clinical history, a treatment plan will then be initiated.
So the next time you have back pain, remember that you may not need anything more than over-the-counter medicine, but if any of the “Red Flags” are present you should contact your health care provider.
GUEST COLUMNIST: Dr. Stallman is radiologist with Radiological Consultants, Inc. He practices at Advanced Imaging Specialists in Dunmore, Northeast Pennsylvania Imaging Center in Scranton, and at Moses Taylor Hospital.
NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!”
This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
Summer is almost here! Soon it will be time for the Mackarey and Cali families to embark on their annual summer vacation to visit one our country's national parks. For the past 10 years we have had the good fortune to visit these spiritual places of natural wonder and beauty. Many of these parks are on the west coast and require several hours of travel through different time zones by airplane. This year will be no different as we plan to visit the Pacific Northwest; Olympic National Park and Mount Rainier National Park.
However, with age I have noticed a slight change in the ability of my body to adjust to different time zones after many hours of travel. Getting off the plane, driving a few hours in a rental SUV, putting on my backpack, and hiking in the woods for several hours requires a little more time to acclimate than it did a few years ago. With this in mind, I would like to share some current wisdom and my personal experience to help ease the pain of jet lag for other active travelers.
Jet lag is considered to be a type of sleep disorder associated with long distance travel between time zones. When traveling between time zones, the natural sleep/wake cycle (circadian rhythm) of our body is disrupted by the change in pattern in daylight. This change can play havoc on many of the body’s natural functions including temperature regulation and hormone balance. The disruption to the body’s biorhythms is more than just simple sleep deprivation. It can be a much more difficult recovery than a few hours sleep and can ruin an active vacation.
Our upcoming trip to the Pacific Northwest is one such example. If we get up early (5 am), travel to Philadelphia, depart at 7 am, fly to Seattle and arrive 6 hours later (minus 3 hours for time zone change), we will be in Seattle at 10 am. If we get to a trail and hike all day, get to the cabin late, wash up, and eat at 7:30. But, it will actually be 10:30 pm and we will be exhausted, confused and thrown off schedule and our biorhythms will be spastic. Instead, we plan to leave at 8 pm arrive at 11 pm, (including time zone change), get a car, check in and get a good night’s sleep (maybe with a sleep aid) before we begin our adventure the next morning.
As with most changes to the body, the results can be mild, moderate or severe. The more time zones crossed, the longer the trip, and the weaker the body prior to the trip all contributes to the severity of symptoms. Typically, it takes one day to adjust to a new time zone for every time zone crossed during travel. But, keep in mind, a readjustment is necessary on the return trip. For example, it can take up to three days for me to readjust to the east coast upon my return from the pacific coast. That explains why people returning from a vacation often feel they need another vacation before returning to work. Also, the older a person is, the more severe the symptoms and the longer it takes to adjust and readjust upon return.
While there is no specific test to diagnose jet lag, if you have the symptoms usually associated with jet lag, you do not have to see a doctor immediately. However, if symptoms last longer than 10 days, there may be another explanation for your symptoms and you should consult with your physician.
There is no fool proof method to prevent jet lag; however, there are measures one can take to lessen the symptoms.
Treatment of jet lag is debatable. Some medical professionals advocate the use of the hormone melatonin. It is an unproven over-the-counter supplement that is taken before bed on the day of travel and for the first four days of travel. More common is the use of prescription sleep medications such as zolpidem (Ambien), to be used to assist in sleeping during the appropriate time in the new time zone. Melatonin and Ambien have side effects and should be discussed with your physician before use.
Sources: Harvard Medical Publications; International Society of Travel Medicine (http://www.istm.org)
This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an affiliated faculty member at the University of Scranton, PT Dept.
Runners are addicted to running for good reason. There is nothing like it! No exercise offers so much in such little time. For example, the caloric expenditure while running is higher than for most other exercises, including biking. Also, it allows for fresh air and beautiful scenery with a minimal investment in clothing or equipment. It requires little skill and time to learn. Runners suffer from less depression, colds and flu symptoms, and experience less pain due to an endorphine release (natural chemical in the brain associated with euphoria and pain control) that is greater than found in other sports and activities. These are some of the motives that cause people to run every day, in spite of the constant loading and wear and tear on the joints.
To be a competitive runner and have longevity in the sport, optimal form is necessary. Moreover, a recent study shows that a runner can decrease the stresses on the lower body and reduce the incidence of stress fractures when trained to run with proper form using visual feedback while on a treadmill. The application of this information has significant implications for training programs for runners for the prevention and recovery from injury. One such low impact method is called the “Pose Running Technique,” by Dr. Nicholas Romanov. It is a “soft landing” method which promotes; an S-like body position with slightly bent knees, a slightly forward lean at the ankles to employ gravity and momentum, lifting the feet up under the hips, and landing on the ball of the foot under the body to absorb the center of mass.
It is my opinion, that the best runners, with the least injuries, such as Jordan Hoyt, speedster from Abington Heights, employ these techniques naturally. Additionally, many of the world’s best runners use coaches and trainers to assist them in their quest for success and injury prevention by using perfect form. However, for the rest of us, we must learn to maximize the efficient use of the body as it works with, not against gravity. We must learn to run “soft” to prevent injuries.
(Runner’s World)
SOURCES: Runner’s World, Pose Running Technique (www.posetech.com), Journal of Orthopaedic and Sports Physical Therapy.
This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an affiliated faculty member at the University of Scranton, PT Dept.
Spring has arrived and baseball season is around the corner. It is hard to believe that a healthy young little leaguer has to worry about injuries. They seem so flexible, agile, strong, and fast. Unfortunately, because their bones are not fully developed, they are vulnerable to “Little League Elbow.” Little league elbow is an injury to the growth plate on the inner aspect of the elbow. The growth plate, where the muscles of the wrist and forearm attach, is also called the medial epicondylar apophysis. This undeveloped and immature boney area is greatly stressed in sports and activities that require repetitive throwing motions.
Repetitive throwing is the most common cause of little league elbow. The two phases of the throwing motion that stress the growth plate most are the early acceleration phase and the release phase. During the early acceleration phase, when the thrower changes from windup to throwing, the muscles of the forearm and wrist pull a traction force through the growth plate. In the release phase, a powerful inward and downward snap of the wrist cause the muscles and ligaments to pull on the growth plate. The growth plate in the elbow is vulnerable to injury because it is made up growth cartilage. The cartilage is immature and softer than bone, muscles, tendons or ligaments. As the thrower continues to repeat the trauma without enough rest, the cartilage weakens and develops small cracks. Eventually, it may pull away from the bone.
Pain on the inner aspect of the elbow is the most significant sign of little league elbow. The pain can occur as a sudden sharp pain after a hard throw or a gradual onset from repeated trauma over the season. In addition to pain the thrower may experience tenderness to touch, swelling, redness, and warmth on the inner aspect of the elbow.
*American Journal of Sports Medicine
Visit your doctor regularly and listen to your body.
Read about preventing youth baseball injuries.
This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an affiliated faculty member at the University of Scranton, PT Dept.
Youth baseball can be a very rewarding experience for young participants, parents and coaches. Keep in mind, I am the eternal optimist…finding good in almost all situations! Generally, well-intended people dedicate countless hours to develop and maintain baseball fields, organize schedules, and instruct basic baseball skills. However, most coaches, without a medical background or additional training, may not have the skill and knowledge to provide a healthy and safe environment.
Temple University Sports Medicine Center in Philadelphia offers several health tips for little league baseball. This information, along with conversations with local orthopedic physicians, and my own 20+ years of experience, will hopefully assist youth baseball coaches in providing a healthier and safer season.
1. Children Are Not Adults: The number one rule to prevent serious injuries in youth baseball is to remember that children are NOT small adults. Therefore, they should not be treated the same way. Their bodies CANNOT take the same amount of stress as an adult because their bodies are still growing and are vulnerable to certain problems. Little league elbow and shoulder are two of the best examples.
2. Warm –Up: A warm-up routine is essential prior to stretching. A short jog, two to three laps around the field, will serve to warm up muscles and tendons prior to stretching.
3. Stretching: Following a warm up, stretching is essential. Upper body includes: hands behind head, hands behind back, elbow across chest. Lower body includes: Indian sit, hurdle stretch, hamstring stretch lying on back, calf stretch.
4. Protective Gear: Coaches should do their best to insure the use of mandatory protective gear (helmet, jockstrap/cup) and encourage the use of optional protective gear (face guard, batter chest protector, mouth guard) depending on age group.
5. Pain/Swelling: Coaches should not encourage youngsters to play through pain. Pain and swelling are usually warning signs of injury or a minor problem that can lead to a serious injury. Remember children have growth plates at the ends of their bones that are not fully fused.
6. Rest: The most important treatment for most sprains and strains in children is rest. It is also the best way to prevent overuse injuries such as little league elbow and throwing shoulder tendonitis.
7. Pitch Count: College and professional pitchers DO NOT count innings, nor should little leaguers. Count Pitches 9-10 year olds: 50 per game 75 per week, 1000 per season, 11-12 year olds: 75 per game, 100 per week, 1000 per season, 13-14 year olds: 75 per game, 125 per week, 1000 per season as recommended by the American Journal of Sports Medicine.
8. Treatment of Most Minor Injuries in Little League:
9. Change Position:
10. Summer Safety:
REMEMBER: Kids are not small adults! Keep it light and have FUN!
Visit your doctor regularly and listen to your body.
NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!” on Little League Elbow.
This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an affiliated faculty member at the University of Scranton, PT Dept.
Guest Columnist: Nancy N. Wesolowski, OT, MS, CHT
Summer is finally here and gardeners in northeast PA are anxious work in their gardens and enjoy the fruits of their labor. I have noticed that my associate, Nancy Wesolowski, certified hand therapist, has recently had an influx of patients with hand injuries associated with gardening. As a result, I have asked her to share her expertise on the prevention of hand injuries associated with gardening….
A relaxing and enjoyable activity for many, gardening can turn dangerous without proper precaution as repetitive stress injuries, tendonitis and Carpal Tunnel Syndrome can stem from raking, weeding, digging and pruning. Additionally, simple scrapes, blisters, and bites can turn into serious problems if not treated appropriately. Since prevention is the best approach, the American Society of Hand Therapists (ASHT) promotes warm-up exercises and injury prevention tips to help all levels of gardeners avoid serious and long-term injuries while enjoying this popular outdoor activity.
ASHT recommends following these upper extremity warm-up exercises prior to gardening:
Note: These exercises should never be painful when completing them. You should only feel a gentle stretch. Hold 10 seconds and repeat 5 times. Should you experience pain, please consult a physician or hand therapist.
ASHT recommends the following guidelines to prevent injury and foster healthy gardening practices:
NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!”
This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an affiliated faculty member at the University of Scranton, PT Dept.
Last month, I wrote a column on the Creatine, an unproven performance enhancement supplement, in response to a mother’s concerns for her son’s health and safety. Many of you wrote emails and asked for more information regarding other popular supplements used by athletes such as prohormone, also known as “andro.” Please find this column satisfactory.
The controversy over the use of prohormone nutritional supplementation in humans (andro) has continued since the investigations of popular athletes such as: Floyd Landis, Barry Bonds, Mark McGwire and others. As a result, many young athletes and their parents, are confused and vulnerable regarding the use of these products in hope of improving performance. A recent study in the American College of Sports Medicine found, while these supplements are widely marketed, the scientific data supporting the effectiveness is lacking. Dr. Gregory Borowski, a local endocrinologist assisted me in the research for this column. He agrees with this study and shares the concern for supplement users due to the lack of scientific data
Prohormone nutritional supplements, also known as “andro,” consist of dehydroepiandrosterone (DHEA), androstenedione, and androstenediol. DHEA is a naturally occurring hormone in the body produced by the adrenal gland.
Marketing professionals purport that these supplements are converted to testosterone and improve the response to weight training. Furthermore, they promise improved athletic performance. In 1998, following the media attention on then home run king, Mark McGwire, sales of “andro” increased at a staggering rate.
Research published in Pediatrics, has also shown that the media, sports figures, peer pressure and coach recommendation have had a major influence on the use of supplements in teens. For example, the study found that girls who expressed a desire to look like beautiful women in movies and magazines were more than twice as likely as their peers to use supplements at least weekly to improve muscle mass or definition. Boys who read men’s heath, fitness or fashion magazines were also more than two times as likely. Weight lifting and football, more than any other activity or sport, were linked to the increase use of supplements such as creatine, amino acids, DHEA, growth hormone and steroids.
Unfortunately, the Anabolic Steroid Control Act of 1990 did not classify androstenedione type products as anabolic steroids. Therefore, these products could be legally purchased as dietary supplements. Fortunately, The Anabolic Steroid Control Act of 2004 amended the 1990 act to include any drug or hormonal substance, chemically and pharmacologically related to testosterone. This law now included androstenedione with other anabolic steroids and required a prescription to purchase these products.
(not validated by scientific research)
In summary, a thorough review of the literature shows that there is no benefit in using prohormone nutritional supplements. Furthermore, since 2004, these supplements cannot be purchased without a physician prescription and have many more potential risks than benefits. Coaches, athletic trainers, educators, parents, nurses and physicians should actively discourage the use of these products.
Visit your doctor regularly and listen to your body.
This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an affiliated faculty member at the University of Scranton, PT Dept.
