Exercise and Aging - Don't Limit the Patient to Limit the Pain

A Reuters news item last week reports that "baby boomers" are accumulating wear and tear injuries, and they should consider cutting back on amount and type of exercise they get.

The article points out that contributors to injuries are biomechanics, poor flexibility, and "pounding" or stomping down unnecessarily hard when running, jumping, walking, etc. Even with that knowledge, the news report goes on to say the answer to reduce injuries is to cut back activity. In Sunday's Fitness Fixer post, Forearm, Upper Body and Hand Exercise, I wrote that it is not a healthful or useful solution to "limit the patient to limit the pain."

The Reuters article quoted a foot and ankle podiatrist saying, "It is really important that people continue to be physically active, but they need to think logically about how to remain active as they age… Probably when you start getting into your 40s and 50s, the half marathon is a great alternative (to full marathons). Or, if you did two or three marathons a year, cut it back to one a year or opt for 10K or 5K runs." The podiatrist himself is a marathoner. He stated, "Having run 25 marathons, it was hard for me to cut back."

I would suggest looking at biomechanics, poor flexibility, and "pounding" first, before telling someone to stop doing what they love:

• Biomechanics - Why So Many Aerobics Injuries?
• Flexibility - What Does Stretching Do?
• Pounding - Walk Lightly - Shock Absorption for Happier Joints

I have some exciting developments about getting you information on Exercise and Aging. Will announce soon.

Labels: aging, fix pain, impact, injury, myths, running

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Runner Fixes More Pain With Straighter Push-Off

Last year, reader Ted fixed back pain by learning to use neutral spine during running and daily life. This week he checked in to say the back is still fine, and that he went on to fix other painful sites.

Fixing pain and injuries by doing some exercises may temporarily ease symptoms. Instead, you can stop the source of injury by making movement habits healthy while exercising and moving through daily life, so that you can get exercise at the same time that the area can heal, and the pain not return.

Ted writes:

"Dr Bookspan, last summer, you helped me return to running, and did an article on me and how the neutral spine fixed my back problem with running.

"The back is a NON ISSUE. Thank you so much.

"Currently, I am working on hip/hammy/knee issues (probably due to over-training). Just thought I would share a thought on the ''Duck Foot'' issue you had talked about (I read the Fitness Fixer religiously). While running on the padded infield of the Stadium Football Field, I was still noticing pains in my hip (caught my foot on the ''upswing'' during a run, hip has hurt off and on since October).

"I focused on my feet, specifically, how I pushed off after the foot-strike (very soft, I often scare other runners because they can't hear me coming up on them). A straight push off after the foot-strike made the pain go away (probably because it aligned my foot/knee/hip during the movement). Also, when the knee pain flared, tensing my quads made it go away.

"I have enjoyed reading your ''Running Articles' please keep 'em coming.
AND
Thank you for fixing my Back.
Much Appreciated,
Ted H"

"Ps. I got your new book (Health & Fitness THIRD edition). VERY good info, I'm trying to use it everyday."

To fix the source of pain, it works best to understand healthful movement retraining and not just "do" a series of rules. One important example is keeping feet parallel or facing forward. The idea is to understand that a straight push-off comes from keeping all the joints in the kinetic chain from feet to hip and spine from twisting in unhealthful ways, not just straighten one segment by twisting another. Yanking or forcing the feet straight is not the point of good positioning.

Ted has more helpful stories to come in future posts. Click these posts for more:

• Back Pain From Running - Ted's story
• Spotting Back Pain During Running and Walking - What Do Abs Have To Do With It?
• Walk Lightly - Shock Absorption for Happier Joints
• Which Shoes Help Exercise, Fall Prevention, and Ankles?
• Plantar Fasciitis Part I
• Health & Fitness Third Edition at Last

Labels: feet, fix pain, impact, knee, readers inspiring story, running

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Walking Softly Benefits Olympic Wrestler

Reader Dennis is an Olympic Medalist in wrestling. He is the student who asked me how to walk without shocking his joints in the post Walk Lightly - Shock Absorption for Happier Joints.

Not long after, I saw Dennis running by at a fast clip, with beautiful neutral spine, good leg and foot alignment, and a light landing with each foot-fall. I asked him why he had asked about running lightly. He said he changed to running lightly after I worked with him on it. I asked if it made a difference and he laughed, "Of course. It used to hurt."

Dennis is muscular and squarely built. He used to leave an impression on the floor when he walked, and had knee, neck, and lower back pain after running.

Landing without jarring reduced pain. Dennis also did several things to stop injuring his joints during movement:

• Stopped keeping a large inward curve in the lower back while running. Changing to neutral spine decreased the compressive pinching and loading of the vertebral joints and soft tissue - Spotting Back Pain During Running and Walking - What Do Abs Have To Do With It?

• Stopped letting his arches flatten downward. Using his own leg and ankle muscles, Dennis held neutral foot position maintaining a good arch without needing any inserts or special running shoe - Arch Support Is Not From Shoes.
  
  
• Stopped letting the knees bend inward toward each other when running, and held neutral foot position - Healthy Knees.
  
  
• Held upright head and neck position instead of jutting the chin forward - Common Exercises Teach Upper Back and Neck Pain.

Using the information in my classes, Dennis fixed recurring ankle injuries, and various back neck and other joint pain and went on to win medals in wrestling. His stories and photos will follow in posts to come.

Labels: feet, fix pain, impact, readers inspiring story, running, walking

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A Reader Asks About Osteoporosis and Walking Lightly

One good question launched many answers. The post Walk Lightly - Shock Absorption for Happier Joints explained a light step prevents joint, soft tissue, and plantar fasciitis pain. In the comments, Carol asked if there were, "a connection between walking lightly and oesteopenia?" This is interesting, since osteopenia is lower than normal bone density, lack of enough pulling or tension on the bones reduces bone density, and a certain amount of vibration may help bones. The simple answer seems to be, that walking lightly should not be enough to reduce bone density, by itself.

Walking, running, and jumping lightly is good exercise to load the bones, while being better for your ankles, knees, hips, and spine than jarring with each step. The post Why So Many Aerobics Injuries? cited news accounts attributing joint pain and injury to high impact activities, with examples of popular aerobics personalities of the 1980s who now say they are too crippled to exercise. Their injuries were avoidable, but not by avoiding impact exercises. Impact activities can be done safely by not stomping down hard. Even repeated jumps from a height can be done with soft landings. Good athletes run, jump, and box with far less impact than most people walk, and have good strong bones. Exercise, done right, is crucial for your bones - Exercise is More Important Than Calcium Supplements for Bones.

When muscles pull your bones during walking, running, and other exercise, the pulling increases bone density. Adding external weight loads bones further. That is a major way weight-bearing and weight lifting exercise increases bone density. The effect of muscles contracting to provide good shock absorption when moving also pulls on the bones,which should be good. The post Forensic Anthropology and Bone Density looked at influencing the shape of our bones by how we move.

The reader went on to comment, "I have always been very light on my feet, and now in my 50s I have found out I have low bone density. I have a cousin who shakes the house when she walks who has been told that she doesn't ever have to worry about her bone mass." Walking lightly alone should not have caused the osteopenia. Questions would be, what other exercise the reader does, and what things might be decreasing her bone density? For the cousin, "shaking the house" by itself may not be enough bone stimulus that anyone could tell her that she "doesn't ever have to worry." Has the cousin taken a bone density test and was found to be high (for whatever reason)? Then you can say there is lowered risk of fracture. Is this cousin is very heavy, which helps load bone? Does this cousin do regular exercise to increase her bone density? It is not likely to be a valid prediction that someone never has to worry about bone density just because they walk badly.

The reader went on to ask, "I went to a bones for life class and was taught to do heel bouncing to stimulate bone growth. i.e. dropping repeatedly from toes onto heels while standing in proper alignment. Do you agree with that exercise?" I did a few searches on the bones for life class and found that the class uses many exercises, not bouncing on the heels alone. Bouncing for a few minutes would not be enough to undo sedentary life style, and the various things people do that actively take away from bone density. You need to do all the other exercises. How much the shock wave of the impact may additionally load or stimulate the bone is still an open question.

There are studies looking at effects of vibration and tapping on bone building. Mechanisms have been studied from the effect on cat bones of their purring, to various machines that bang or vibrate. Some advertising for vibration machines goes as far as making claims that they will increase bone density. So far, none have been found to have as much bone building effect as muscular activity (exercise). Too much occupational vibration, like jack-hammer, helicopter and similar environments produces joint pain, injuries to the spine, eyes, ear, nervous, and other systems. That was one of the topics I was looking into when I did aviation medicine research. A news article that came out on last year's fitness fad of vibration plates promising weight loss and fitness building, mentioned a few of the problems with too much vibration, and, ironically had an accompanying photograph showing severely hyperlordotic (overarched) lower spine positioning by a person listed as the trainer. Hyperlordotic spine posture, by itself, damages the facet joints of the spine over time. It seems safe to say that the jolting of the vertebral joints against each other in this overly arched position would only be worsened by vibration. The post Prevent Back Surgery shows examples of overarched lower spine and why it causes so many injuries in fitness.

It would be interesting to know if low levels of vibration, through tap dancing, Flamenco dancing, pogo stick jumping, and similar activities, would change bone compared to the same amount of exercise without the impact. Some studies claim that swimmers or cyclists do not have as high bone density as runners, while others do not find that when they control for the direct muscle work applied to the area. There are even studies showing that Tai Chi, a most mild form movement with almost no foot-falls at all, can increase bone density in older people, just from the movement.

Along with walking or running, and weight lifting to build bone density, and using your muscles to stop stomping which can hurt the joints, you can prevent bone loss by avoiding things that reduce bone density:

• Smoking
• Drugs that are known to greatly increase risk of bone fracture: stomach acid drugs and steroid anti-inflammatory drugs, regular use of SSRI antidepressants such as Prozac and Paxil. Numerous medications used to treat different cancers may produce osteopenia (bone shortage) and osteoporosis in long-term cancer survivors. See Stomach Acid Drugs Increase Osteoporosis and Hip Fractures
• Lack of sunlight. Calcium cannot be absorbed or do its job without enough sunlight
  
• High consumption of meat and dairy products
• Drinking alcohol too often
  
• Lack of fruit and vegetables, and vegetable calcium sources
• Eating wheat and related grains by people with celiac
  

Osteoporosis and osteopenia cause major problems for men, not only women. More on this to come. Move, walk, lift weights, stand on your hands, and jump for fun, exercise, and bone building. You do not need to ooze around on tiptoe to avoid impact injuries. Jump and dance and stamp your feet for fun, without jarring your joints and retinas loose. Have fun.

Carol ended her comment to me with, "Thanks for your site - I've learned a lot about alignment, which has helped in many ways." Thank you Carol for writing so many helpful questions for our benefit.

Labels: aerospace, biking, facet joints, fix pain, impact, injury, osteoporosis, plantar fasciitis, swimming

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Fast Fitness - Leap for Balance on Leap Year

Here is Friday Fast Fitness for the intercalary year (Leap Year) - Leap to develop ankle and knee stability, leg power, and balance.

1. Leap forward, landing on the other foot with soft shock absorption. Don't land hard, which jars joints.
2. "Stick" your landing, without wobbling or setting the first foot down.
3. Leap backward to the original foot and place. Hold your landing steady. Try several leaps forward and backward, then change the leading leg and repeat.

When landing, keep ankle stable by preventing your foot from rolling to the outside. Info in the post No More Ankle Sprains Part II.
Train knee and hip stability by preventing your knee from swaying inward upon landing - Healthy Knees.

Labels: ankle, balance, fast fitness, feet, hip, holiday, impact, knee, leg strength, sprain

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Walk Lightly - Shock Absorption for Happier Joints

"Your tread must be light and sure
as though your path were upon rice paper

"This rice paper is the test
Fragile as the wings of the dragonfly

"Clinging as the cocoon of the silkworm
When you can walk its length and leave no trace
You will have learned"
- Master Khan to Grasshopper in the 70's TV series Kung Fu

Walk, run, jump, and move lightly.

Banging down with each step is not good for your body. It increases risk of joint pain and plantar fasciitis.

I tell my students to stop banging and stomping when they walk and move and jump. One day, a student asked me "How?" Here are some things to try:

1. I asked the student to stomp his foot.
Then I asked him to place his foot down lightly. That is how.

2. Use an analog bathroom scale. Step on heavily and see the numbers go up high. Then step on again lightly and see that the last number reached is a lower number. In sports medicine, we use force plates to measure ground forces when an athlete jumps or runs by.

3. While walking, try not to make noise. It doesn't mean to tip-toe, but to walk with regular heel to toe gait, but lightly.

4. Try walking with a full-to-the-brim cup of hot coffee or any liquid. Don't tip-toe, just walk softly without spilling any.

5. Practice jumping in the air and landing softly. Bend your knees when landing. Increase the height of the jump, maintain soft landing. Work up to jumping down from increasing heights without making a sound, or much sound.

Labels: arthritis, feet, impact, knee, leg strength, martial arts, plantar fasciitis, running, walking

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