Recently, a reader shared with me their concern about the aging process. They were not happy with the changes in their body, despite exercising regularly. New research suggests that there may be some forms of exercise that are better than others to counteract the aging process. With the accumulation of more and more birthdays, I too, am concerned about the changes in my body!
The deterioration and degeneration of the body associated with the aging process is well-documented and the musculoskeletal system is no exception. As we age, weight bearing joints of the lower body (hips and knees) frequently suffer from wear and tear degeneration. Loss of muscle mass and strength is also common with age. Specifically, damage to older muscles has been found to regenerate slowly and incompletely and the problem runs as deep as the cellular level as the mitochondria diminish in quality and quantity. However, there is good news: a recent study published this spring in Cell Metabolism suggests that certain types of exercise can actually regenerate and reverse the aging mitochondria.
As popular and common as exercise is, little is known about the influence and impact it has on the cellular level. A research team at the Mayo Clinic decided to answer this question and conducted an experiment to determine the cellular effects of different types of exercise on aging muscles.
The Mayo team chose 72 men and women and separated them into two groups: 30 and under and older than 64. All subjects were healthy but sedentary. Pretest analysis was performed for blood sugar levels, gene activity, muscle cell mitochondrial health, and aerobic fitness level. Subjects from the 30 and under group and the over 64 group were randomly assigned to one of four research groups.
Group One: Vigorous weight training 3-5 times per week, Group Two: Interval aerobic exercise on a stationary bike (pedaling hard and fast for four minutes followed by a recovery at a slow pace for three minutes then repeating the sequence 3 or more times) 3 times per week, Group Three: Moderate aerobic exercise on a stationary bike for 30 minutes 2-3 days per week and light weight lifting on the other 2-3 days, Group Four: Control group who did not exercise. After 12 weeks, lab tests were repeated and data compiled and analyzed.
In the 30 and under group as well as the over 64 group, all three experimental groups improved in fitness level and blood sugar regulation. As expected, Group One, the vigorous weight training group, showed the greatest gains in muscle mass and strength. Also, not surprisingly, Group Two, the interval training group, had the greatest gains in endurance. However, the most unexpected results came when retesting the muscle cells by biopsy. Only group two, the interval aerobic exercise group demonstrated the most significant improvement in the activity levels of their genes in both the young and older groups, when compared to the vigorous weight training and moderate exercise groups.
Moreover, the positive improvements in the genes of the older group far surpassed that found in the younger group. For example, in the younger group, 274 genes improved compared to 170 genes in the moderate exercise group and 74 in the vigorous weight training. In the older group, 400 genes were improved in the interval aerobic group while 33 for weight training and 19 for moderate exercise groups.
It is well known that loss of muscle mass and strength is common with age. Specifically, older muscles have been found to regenerate slowly and incompletely, and the problem runs as deep as the cellular level as the mitochondria diminishes in quality and quantity. However, this study suggests that interval aerobic exercise can regenerate and reverse the aging mitochondria. Healthier mitochondria can produce energy for muscle cells to function at a higher level.
Interval aerobic exercise can have anti-aging effects. In fact, the older your muscles, the more you will benefit from, not just moderate exercise, but more vigorous interval aerobic exercise. Furthermore, interval training may be applied, not only to aerobic exercise, but to weight training for the upper and lower body. According to the American College of Sports Medicine, high intensity interval training, also called HIIT workouts, involves a repetition of a series of high-intensity exercise (aerobic or weight training) for a specific period of time (3-5 minutes) followed by a specific period of rest or low-intensity exercise (1-3 minutes).
The intensity can be increased by speed or resistance. HIIT workouts have been associated with increased caloric expenditure with less exercise time, as well as improved strength and endurance. Most recently, it has been found to improve cell energy in the aging population. However, do not attempt to increase the intensity of your exercise program without consulting with your physician first. Once medially approved, consult with a Doctor of Physical Therapy to create a program specifically designed for you.
Therefore, if your gene pool is questionable like most of us, don’t use that as an excuse. There are things you can do to have a positive impact on your DNA to live longer and healthier…one of them is EXERCISE!
Visit your doctor regularly and listen to your body. Keep moving, eat healthy foods, exercise regularly, and live long and well!
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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 orthopedic and sports physical therapy in Scranton and Clarks Summit. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at Geisinger Commonwealth School of Medicine. For all of Dr. Mackarey's articles, visit our exercise forum!
I think we would all agree, technology is a wonderful thing. However, like all good things, it comes at a price. Students and workers alike are suffering from the many physical effects of sitting for too many hours. Studies show the impact of prolonged sitting, especially with proper posture, are multifaceted: pain, headaches, vision problems, poor concentration, excess fat storage with weight gain. Studies strongly support the use of good posture, ergonomic workstations, posture stretches, frequent changes of positions, including the use of standing desks to prevent pain and injury. In fact, standing desks are not a new invention; they have been used by many to promote health and stimulate thought…Hemingway, Franklin and Jefferson all stood while they worked.
The average head weighs 10 to 12 pounds and when tilted down at a 45 degree angle the forces of gravity are multiplied by 5. While reading, studying or working on the computer with poor posture, one must support 50 or more pounds of pressure on the neck, middle and lower back for hours on end. It is no wonder why this activity is associated with headaches, neck and back pain, numbness and tingling in arms and legs, muscle spasms etc. Some studies report the lifetime prevalence of neck and shoulder pain in office workers as high as 80%.
Recent research has also correlated the amount of time an individual sits to a decrease in their average life expectancy. Seriously, watching television and sitting is literally killing us. The Heart and Diabetes Institute of Australia conducted extensive research on sedentary behavior, including a review of almost one million people. They used actuary science, adjusted for smoking, waist circumference, and diet and exercise habits to assess the specific effects that the hours of sitting in a day impacts a person’s life span. They found that sitting too long results in a decrease in muscle contraction of the big leg muscles and because these unused muscles need less fuel, more unused glucose (fuel) is stored in the muscle. High glucose levels result in high blood sugar, which leads to adult-onset diabetes and other health issues.
The deleterious effects of sitting in children have also come under scrutiny and it may impact the classroom. Due to technology, today’s classroom is more advanced in many ways. However, the traditional hard chair and desk remain unchanged. Not only are these, “one size fits all,” desks uncomfortable, current research suggests that they may also limit learning.
Recent studies show that standing desks promote not only a physically healthier child by expending more calories and lowering obesity but also improves focus and concentration to improve academic outcomes.
Research from Texas A&M Health Science Center found two landmark things about children who worked at standing desks such as Stand2LearnR, when compared to those seated: One, children burned more calories and obese children burned more than normal-weight peers. Two, children were more attentive in the classroom and engaged more with their teacher and their work when allowed to stand. Teachers in the study not only found the results to be favorable for fidgety, high-energy kids, but those who tend to be overweight and tired benefited greatly.
Researchers were quick to point out that there may be many ways to promote movement and limit sitting in the classroom that may also promote learning in a healthy way such as sitting on exercise balls or inflatable discs.
The average office worker sits for more than 10 hours per day between office work, sitting at lunch, checking email and social media at home. Amazingly, studies suggest that even vigorous exercise before and after work cannot overcome the damage from prolonged sitting. New products such as the “TrekDeskR,” allows a worker to work on a computer, phone, or do paperwork, while walking on a treadmill, has great health value. Also, other products such as VariDeskR, allows for frequent positional changes from sitting to standing while working. Even without using a standing desk, changing positions, such as standing during phone calls or meetings has proven to be valuable. Current Wisdom: Alternate standing (30-45 minutes) and sitting (15-30 minutes)
Spine problems can be prevented with good posture and proper body mechanics. Poor posture and improper body mechanics subject the spine to abnormal stresses that, over time, can lead to degeneration and pain. Good posture and proper body mechanics and frequent changes in positions, can minimize current spine pain and prevent recurrent episodes. Posture is the position in which you hold your body upright against gravity. Good posture involves positions that place the least amount of stress on the spine. Good posture maintains the spine in a “neutral” position. In a neutral spine, the three normal curves are preserved (a small hollow at the base of the neck, a small roundness at the midback and a small hollow in the low back). When viewed from the side, the upper back appears straight with a small hollow in the lower back.
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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 orthopedic and sports physical therapy in Scranton and Clarks Summit. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at Geisinger Commonwealth School of Medicine. For all of Dr. Mackarey's articles, visit our exercise forum!
In 2000, President Bill Clinton dedicated March as National Colorectal Cancer Awareness Month. The purpose of this designation is to increase public awareness of the facts about colon cancer – a cancer that is preventable, treatable and has a high survival rate. Regular screening tests, expert medical care and a healthy lifestyle, which includes a proper diet and exercise, are essential for prevention. Several studies have demonstrated that exercise can also help prevent colon cancer.
The American Cancer Society estimates that there will be approximately 107,000 new cases of colorectal cancer in 2023. Of these, 52,550 men and women will succumb to the disease. It is the second-leading cause of U.S. cancer deaths for both men and women combined. The good news is incidence and mortality rates are dropping both nationally as well as in northeast Pennsylvania. The bad news is northeast Pennsylvania still has increased incidence and mortality rates when compared to the national average.
Studies show that prevention of this disease is multifaceted and includes: engaging in daily exercise, eating a low-fat diet with little red meat, avoiding smoking, drinking in moderation and having regular colonoscopy screenings.
Early detection is the key to survival. Death from colorectal cancer can be eliminated if caught at the earliest signs of disease. Colorectal cancer progresses very slowly, usually over years. It often begins as non-cancerous polyps in the lining of the colon. In some cases, these polyps can grow and become cancerous, often without any symptoms. Some symptoms that may develop are: blood in stool, changes in bowel movement, feeling bloated, unexplained weight loss, feeling tired easily, abdominal pain or cramps, and vomiting. Contact your physician if you have any of these symptoms.
The risk of colon cancer increases with age, as 90 percent of those diagnosed are older than age 50. A family history of colon cancer increases risk. Also, those with benign polyps, inflammatory bowel disease, ulcerative colitis or Crohn’s disease are at greater risk and should be screened more frequently.
The intestine works like a sewage plant, recycling the food and liquid needed by your body. However, it also stores waste prior to disposal. The longer the wastes remain idle in your colon or rectum, the more time toxins have to be absorbed from you waste into the surrounding tissues. One method in which exercise may help prevent colon cancer is to get your body moving, including your intestines. Exercise stimulates muscular contraction called peristalsis to promote movement of waste through your colon.
Exercise to prevent colon cancer does not have to be extreme. A simple increase in daily activity for 15 minutes, two times per day or 30 minutes, once per day is adequate to improve the movement of waste through your colon. This can be simply accomplished by walking, swimming, biking or playing golf, tennis or basketball. For those interested in a more traditional exercise regimen, perform aerobic exercise for 30-45 minutes four to five days per week, with additional sports and activities for the remainder of the time. For those in poor physical condition, begin slowly. Start walking for five to 10 minutes, two to three times per day. Then, add one to two minutes each week until you attain a 30-45 minute goal.
Medical Contributor: Christopher A. Peters, M.D - Dr. Christopher Peters is a partner of Radiation Medicine Associates of Scranton (RAMAS) and serves as medical director of Northeast Radiation Oncology Centers (NROC). He is an associate professor of clinical medicine at GCSOM.
Sources: American Cancer Society/Northeast Regional Cancer Institute, and CA Cancer J Clin.
EVERY MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!” via Blog
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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 orthopedic and sports physical therapy in Scranton and Clarks Summit. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at Geisinger Commonwealth School of Medicine. For all of Dr. Mackarey's articles, visit our exercise forum!
Recently, a young woman came to my office with complaints of severe middle and lower back pain. On her first visit, I noticed her beautiful pink purse (big bag) and asked her permission to weigh the bag and discovered that it weighed 8 pounds. While 8 pounds does not seem excessive, the woman weighed 120 pounds and based on the research, would be advised to carry a 2.5-to-3.5-pound bag, (2-3% of her body weight).
A recent study shows that the average weight of a woman’s purse has increased by 38% and now exceeds 6 pounds. Despite technological advances, women have not found a way to simplify their lives, or at least what they think they need in their lives. High tech gadgets have only added weight to a purse already filled to the brim.
On a whim, I decided to ask permission to examine the contents of some of my patient’s purses. A typical purse includes the following: hairbrush, cosmetic bag, mirror, feminine products, keys, and sunglasses, reading glasses, checkbook, wallet, coupons, water bottle, and medications. Additionally, I discovered heavy high-tech products such as cellular phones, tablets, digital Bluetooth earpieces, and rechargers. Lastly, some women add the weight of a book or Kindle to the bag. Studies also show that the larger the bag and stronger the straps, the more items are stuffed in, resulting in a very heavy purse.
It is a pervasive attitude that a woman should never be stranded without her purse full of essentials. So, where is the problem? The problem is that carrying a heavy bag, usually on one side of the body, forces the body to tilt forward and to the opposite direction to compensate. Over time, this change in posture leads to neck, middle and lower back pain.
Consider the following suggestions to promote healthy use of a purse and prevent injury:
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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 orthopedic and sports physical therapy in Scranton and Clarks Summit. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at Geisinger Commonwealth School of Medicine. For all of Dr. Mackarey's articles, visit our exercise forum!
This year, Valentine’s Day is Valentine’s Weekend! And, while you may wonder what that has to do with health and wellness, you might be surprised to learn that love can be good for your health! Studies show that it is in our DNA to seek out good relationships and that these solid relationships can lead to a happier, safer and healthier life. Conversely, infatuation and less committed, volatile relationships that are “on and off,” are very stressful and unhealthy. But those fortunate to participate in a stable and satisfying long-term relationship are the beneficiaries of many health benefits! Whether you have spouse, partner, or close friend, (love is love is love), feeling connected, respected, valued, and loved is critically important to your health and wellness! So celebrate Valentine's Day and enjoy all the love that surrounds you!
SOURCES: WebMD
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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 orthopedic and sports physical therapy in Scranton and Clarks Summit. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at Geisinger Commonwealth School of Medicine. For all of Dr. Mackarey's articles, visit our exercise forum!
Last week’s column was dedicated to Rosie Malloy as we discussed the importance of laughter for health and wellness. In this column, I will discuss one of the most understated benefits of exercise – mental health! Specifically, aerobic exercise (exercise that increases your heart rate for 30 minutes or more) such as walking, biking, running, swimming, hiking, elliptical & stepper machines to name a few, is the secret to “runner’s high.” This exercise euphoria is not limited to runners alone, but all who engage in aerobic exercise are more likely to experience high energy, positive attitude, and mental wellness by helping reduce depression.
Physical activity, specifically aerobic exercise, is a scientifically proven useful tool for preventing and easing depression symptoms. Studies in the British Journal of Medicine and the Journal of Exercise and Sports Science found that depression scores were significantly reduced in groups that engaged in aerobic running, jogging or walking programs, 30-45 minutes 3-5 days per week for 10-12 weeks, when compared to a control group and a psychotherapy counseling group.
Depression is the most common mental disorder and is twice as common among women as in men. Symptoms include: fatigue, sleeplessness, decreased appetite, decreased sexual interest, weight change, and constipation. Many of these symptoms are likely to bring an individual to their family physician. Unfortunately, depression is on the increase in the United States. According to the National Ambulatory Medical Care Survey, in the 1990’s, 7 million visits to a primary care physician were for the treatment of depression. 10 years later the number doubled.
According to copious amounts of scientific research, exercise improves health and wellness and reduces depression in two ways, psychologically (mentally) and physiological (physically).
SOURCES: British Journal of Medicine: Journal of Exercise and Sports Science
EVERY MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!” via Blog
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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.comPaul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopedic and sports physical therapy in Scranton and Clarks Summit. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at Geisinger Commonwealth School of Medicine. For all of Dr. Mackarey's articles, visit our exercise forum!
While I normally do not address the topic of shoveling snow until January, considering recent weather events, I thought it might be valuable to present it sooner. Much has been written about the dangers of snow shoveling for your heart. However, while not fatal, low back pain is the most common injury sustained while shoveling snow. Heart attacks are also more common following wet and heavy snow.
Snow shoveling can place excessive stress on the structures of the spine. When overloaded and overstressed, these structures fail to support the spine properly. The lower back is at great risk of injury when bending forward, twisting, lifting a load, and lifting a load with a long lever. When all these factors are combined simultaneously, as in snow shoveling, the lower back is destined to fail. Low back pain from muscle strain or a herniated disc is very common following excessive snow shoveling.
Sources: The Colorado Comprehensive Spine Institute; American Academy of Orthopaedic Surgeons
Visit your doctor regularly and listen to your body.
EVERY MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!” via Blog
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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 orthopedic and sports physical therapy in Scranton and Clarks Summit. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at Geisinger Commonwealth School of Medicine. For all of Dr. Mackarey's articles, visit our exercise forum!
Recently, two patients asked me when I thought it would be safe for them to return to their exercise programs after abdominal surgery. She stated that she was not sure how to properly and safely implement or return to her program.
This column will attempt to ensure a safe return to activity and exercise following general surgery such as gall bladder, appendix, hernia, etc. The post-operative patient has many questions: When is it safe to begin an exercise program? How do I begin? What is the best exercise? Which exercises are best? How do I know if the activity is too intense or not intense enough? Are there safe guidelines?
Before you begin, discuss your intention to exercise with your surgeon and primary care physician. Get medical clearance to make sure you can exercise safely. With the exception of short daily walks, don’t be disappointed if your surgeon requires you to wait at least until your 6 week post-op check-up to begin exercise.
While a 60 minute workout would be the long term goal, begin slowly at 15-20-30 minutes and add a few minutes each week. Make time to warm up and cool down.
Warm-up 5-10 minutes
Strength Training 10-15-20 minutes
Aerobic 10-15-20 minutes
Cool down 5-10 minutes
How to Monitor Your Exercise Program:
First, determine your resting heart rate by taking your HR (pulse) using your index finger on the thumb side of your wrist for 30 seconds and multiply it by two. 80 beats per minute is considered a normal HR but it varies. This is a good baseline to use as a goal to return to upon completion of your workout. For example, your HR may increase to 150 during exercise, but you want to return to your pre exercise HR (80) within 3-5 minutes after you complete the workout.
For those who are healthy, calculating your target heart rate (HR) is an easy and useful tool to monitor exercise intensity.
220 – Your Age = Maximum Heart Rate
EXAMPLE for a 45 year old: 220 – 45 = 175 beats per minute should not be exceeded during exercise.
For those concerned about calories expended during exercise.
NOTE: Keep the level at a light/moderate level for the first four to six weeks and advance to the moderate/heavy at week six. The Very Heavy Level may not be appropriate for 12 weeks post op is for those who have a reasonable fitness level and exercise 4-5 days per week.
Example of Data Found on Fitness Equipment
Remember, this is only accurate if you program your correct height, weight and age.
Level kCal/min MET
Light 2 - 4.9 1.6 – 3.9
Moderate 5 - 7.4 4 – 5.9
Heavy 7.5 - 9.9 6 - 7.9
Very Heavy 10 - 12.4 8 – 9.9
Always secure physician approval before engaging in an exercise program.
If the patient is on beta blockers (Atenolol, Bisoprolol, etc), it is important to use the Borg Rating of Perceived Exertion Scale (RPE) scale to determine safe exercise stress since exercise will not increase HR as expected:
0 - Nothing at all
1 - Very light
2 - Light
3 - Moderate
4 - Somewhat intense
5 - Intense (heavy)
6
7 - Very intense
8
9 - Very, very intense
10 - Maximum Intensity
NOTE: Keep the RPE at 2-3 the first 6 weeks post op and advance to level 3-4 at 8-12 weeks post op. Levels 5-6-7 are for those with a reasonable fitness level and exercise 4-5 days per week. The advanced levels should not be attained until 2-3 months of exercise and 3-4 months post op.
MEDICAL CONTRIBUTOR: Timothy Farrell, MD, is a general surgeon at GCMC.
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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 orthopedic and sports physical therapy in Scranton and Clarks Summit. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at Geisinger Commonwealth School of Medicine. For all of Dr. Mackarey's articles, visit our exercise forum!
Osteochondritis dissecans, also called OCD, is the most common cause of a loose body or fragment in the knee and is usually found in young males between the ages of ten and twenty. While this word sounds like a mouth full, breaking down its Latin derivation to its simplest terms makes it understandable: “osteo” means bone, “chondro” means cartilage, “itis” means inflammation, and “dissecans” means dissect or separate. In OCD, a flap of cartilage with a thin layer of bone separates from the end of the bone. As the flap floats loosely in the joint, it becomes inflamed, painful and disrupts the normal function of the joint.
Typically, OCD is found in the knee joint of active young men who participate in sports which involve jumping or full contact. Although less common, it is also found in other joints such as the elbow.
Often, the exact cause of OCD is unknown. For a variety of reasons, blood flow to the small segment at the end of the bone lessens and the weak tissue breaks away and becomes a source of pain in the joint. Long term, OCD can increase the risk of osteoarthritis in the involved joint.
To properly diagnose OCD a physician will consider onset, related activities, symptoms, medical history, and examine the joint involved for pain, tenderness, loss of strength and limited range of motion. Often, a referral to a specialist such as an orthopedic surgeon for further examination is necessary. Special tests specifically detect a defect in the bone or cartilage of the joint such as:
Radiograph (X-ray) may be performed to assess the bones.
Magnetic Resonance Imaging (MRI) may be performed to assess bones and other soft tissues such as cartilage, ligaments, muscles and tendons.
The primary goal of treatment for OCD is to relieve pain, control swelling, and restore the complete function (strength and range of motion) of the joint. The age of the patient and severity of the injury determine the treatment methods. For example, medications assist with pain and inflammation reduction.
Young patients who are still growing have a good chance of healing with conservative treatment. Rest and physical therapy are the conservative treatments of choice. Rest entails avoiding any activity that compresses the joint such as jumping, running, twisting, squatting, etc. In some cases, using a splint, brace and crutches to protect the joint and eliminate full weight bearing, may be necessary for a few weeks. Physical therapy, either as a conservative or post operative treatment, involves restoring the range of motion with stretching exercises and improving the strength and stability of the joint through strengthening exercises. Modalities for pain and swelling such as heat, cold, electrical stimulation, ultrasound, compression devices assist with treatment depending on the age of the patient and severity of the problem.
Conservative treatment can often require 3 to 6 months to be effective. However, if it fails, arthroscopic surgery stimulates healing or reattaches the loose fragment of cartilage and bone. In some cases if the defect is small, surgery involves filling in the defect with small bundles of cartilage. In other cases, the fragment is reattached directly to the defect using a small screw or bioabsorbable device. More recently, surgeons are using the bone marrow of the patient to repair the deficit by stimulating the growth of new tissue (bone marrow stimulation).
In other cases, a plug of healthy tissue from the non-weight bearing surface of a patient's knee relocated to the defect to stimulate healing (osteochondral autograft transplantation OATS). While there are many surgical options for OCD, an orthopedic surgeon will help the patient decide the most appropriate procedure based on age, size of defect, and other factors.
While prevention is not always possible, some measures can be taken to limit risk. For example, if a child playing sports has a father and older brother who had OCD, then it would be wise to consider the following: Avoid or make modifications for sports requiring constant jumping. Cross-train for a sport to avoid daily trauma (run one day and bike the next). Also, do not play the sport all year round (basketball in the fall/winter and baseball in the spring/summer). Seek the advice from an orthopedic or sports physical therapist to learn proper strength and conditioning techniques. Learn proper biomechanics of lifting, throwing, squatting, running, jumping and landing.
Sources: Mayo Clinic
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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 orthopedic and sports physical therapy in Scranton and Clarks Summit. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at Geisinger Commonwealth School of Medicine. For all of Dr. Mackarey's articles, visit our exercise forum!
“When is it safe for my child to start weight training?” This is a very common question asked by parents of young athletes who are looking for advice regarding their children’s participation in weight training. This month, for example, I received three such inquiries. While some who are eager to get a “competitive edge” may not be satisfied with the answer, these recommendations are grounded in the scientific literature and medical specialist with the hope to prevent injury and dispel fear and fallacy.
Weight training, weight lifting or resistive training all describes the use of a resistive force on a muscle to improve strength. While much attention has been given to the benefits of weight training in adults, much less has been written about its application in children.
According to the Journal of Pediatric Orthopedics, children less than 12 years old are considered prepubescent or before puberty. Teenagers who are between 12 and 19 are considered to be adolescents. Studies consistently demonstrate that strength gains are much more significant in adolescents than in preadolescents. It is important to note that these strength gains are not only from the enlargement of muscle fibers (hypertrophy), but also from the improvement in the coordination and efficiency in muscle contraction and the recruitment of motor units and fibers within the muscle.
Preadolescents lack the hormones necessary to develop masculine characteristics. Adolescents begin to produce the hormones of testosterone and androsterone to develop secondary sexual characteristics such as pubic hair and enlarged genitalia. In view of this, age 13-14 is the optimal age to safely begin and benefit from a well-designed weight training program.
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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 orthopedic and sports physical therapy in Scranton and Clarks Summit. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at Geisinger Commonwealth School of Medicine. For all of Dr. Mackarey's articles, visit our exercise forum!
