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Hip Pain? Hip Tips...

One of the common complaints I see in my office is that of hip pains, which come in two varieties:  

ACUTE hip pains:   We see these cases a lot as injuries to the groin muscles on the inside aspect of the hip.  These are usually pretty obvious in their origin, for example when a hockey player collides with legs straddling the ice, or when a football player is tackled with one leg extended out to the side.  (Hip fractures are the subject for a separate blog).  These cases often respond quickly, as long as there is no serious tear in the muscle/tendon structure as it inserts from the inner thigh.  Other cases involve the outside of the hip joint, seen with cases of bursitis or capsulitis from extended exercises like rowing, biking, or running.  Treatments include rest, physical therapies like ultrasonic vibrations, electro-stimulation, and medical acupuncture are often all that is required. An anti-inflammatory medication can also help settle things down.  If this is not working, then further investigation with images can prove helpful, and more aggressive treatments like cortisone shots could be considered.  Gentle movements are encouraged, along with a graduated program of stretching and toning of the inner thigh muscles to rehab the area. Assuming the root cause was a one-time injury, recovery is usually excellent.  If continued trauma occurs, then the problems become more chronic.    

CHRONIC hip pains: These occur if the root cause is repetitive, such as the constant pounding felt by rodeo riders, snowmobilers, or moto-cross cylclists. This can lead to the destruction of the cartilage and the build-up of extra bony growth causing osteo-arthritis.   l More commonly, the root cause is just the repetitive effects of gravity as seen in the daily movements of an obese patient.  Especially with the morbidly obese ( 100 pounds or 45 kilograms over their ideal weight) this means the simple acts of standing up, walking, and stair climbing all cause daily damage to the hip joint.  Other conditions such as systemic forms of arthritis can certainly also affect the hip joint itself, leading to “bone-on-bone” instead of smooth surfaces where the hip joint is supposed to move.  Again, we look for any correctable root causes.  This would entail routine blood-work and images, to assess underlying diseases.  It would also involve corrective action for the obese patient, with proper diet and exercise regimens.  In severe cases, that are beyond any such help, replacement of the hip joint may be needed. 

In the meantime, here are some hip tips:

  • Watch your posture: Sitting is hip-hostile.  Try to stand up a few times per hour if you can.  We have already written about the benefits of sitting on a pilates ball for back pains, 
  • it also helps hip pains by introducing some movements into an otherwise frozen posture.  If you can, try to rig your work station for standing up all the time. 
  • Select non-impact exercises, like the bike or elliptical machines in the gym.  Also try yoga and pilates to help with toning and flexibility.
  • Watch your weight.  One of the rules of medicine is that pain is fattening.  If you are in pain, you can’t move much to burn off your daily calories.  This becomes a viscous circle, where any excess calories are simply added to one’s fat stores, adding to the pains of simple movements.  To compound this, junk foods such as white sugar, white flour, etc are all known to cause more inflammation, further adding to the damage to the hips and other joints.
  • See your doctor to seek out underlying diagnoses, from systemic diseases to simple things like one leg being significantly longer than the other.  Depending on the underlying causes, you may also benefit from massage, physical therapy, or chiropractic treatments. Follow their exercise tips to stretch and tone the surrounding hip structures.

For more info,  

http://www.mayoclinic.org/symptoms/hip-pain/basics/when-to-see-doctor/sym-20050684

http://orthoinfo.aaos.org/PDFs/Rehab_Hip_3.pdf

Stress - Use It Wisely and Stay Younger

Are you at that "golden" age when retirement is looming, or has already loomed?   For years, we have all thought of retirement as the reward for a lifetime of work, but the reality is quite different. 

To be sure, we all know how much we enjoy a surprise day off during a blizzard, or our routine free days on the weekend or on summer holidays.  Well, an idle retirement is not just an endless multiple of these marvelous mini-holidays.  The lack of stress leads to boredom, and a lonely sense that all your working friends have forgotten you, which, after a while is quite true.  Soon one day blends into the next, and, with the absense of any time pressures or deadlines, tasks that you used to do quickly in the middle of a busy schedule now drag on for weeks.  The sense of purpose or mission is gone, paradoxically at the time in life when one needs little sleep, and has the greatest levels of intellectual and experiential resourses. 

Those who are married note that their spouses have to make considerable adjustments to their partners constant proximity, many throwing up their hands in frustration, saying "I married you for better or for worse, but not for lunch".  Arguments increase, and, in many cases, eventually conversation itself becomes extinct.  I have been in many holiday resorts such as in Las Vegas, where thousands of retired couples take vacations, and have observed them in restaurants.  Those who are with friends are quite animated, while an alarming number of those couples who are eating alone will sit in silence, each person eating their meals as if there was no one else at the table.  This is in direct contrast to newly-weds, who are in animated conversations discussing their dreams, aspirations, and the stresses that they face each day.  The retired folks, having reached their dream of stopping work, having aspired to endless free time, and having not one stress or challenge left worth talking about, have simply run out of things to say.  The particularily sad part of this scenario that happens to those who retire idly is that the consequenses are far more dangerous than simple boredom or lonliness.  The medical statistics are truly alarming.  Within a few short years, these idle seniors will become  senile, or even dead.  I've seen it happen time and time again with my patients. 

Count Otto von Bismark was the man who arbitrarily picked 65 as the age of retirement, primarily because few people reached that stage in his era.  But many, such as  Winston Churchill, George Burns, Bob Hope, and Sister Theresa,  have ignored this tradition, and continued to work and face considerable stresses long after this age. As a direct result, they all stay young in spirit, and in body, long after their idle peers have passed on or become senile.  Stress makes us think.  Stress makes us react.  It gives us a mission to achieve.  It gives us the fullest possible range of emotions, from  moments of exhilaration to moments of sadness.  In other words stress makes us feel alive, and when it is removed from our lives we suddenly feel and look old.  For centuries man has looked for ways to prolong our lives, and Ponce de Leon, for one, thought he found it.  But the real fountain of youth has been with us all along, and we have not only ignored it in our elder years, but we have actually sought ways to protect ourselves from it.  It seems that even in this age of miracle cures and laser surgery, common sense isn't very common after all. 

Here's an action tip. 

Benjamin Franklin once said "there's nothing wrong with retirement, as long as it doesn't interfere with your work".  

Wise words.  If company or government policy force you from your job, get busy finding new challenges.  If you are voluntarily  dictating your retirement, think again.  Whether it is in the form of taking courses, learning a new language, sport, or skill, or starting up your own small business, stress, as long as it is handled competently, will keep you younger longer
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Dry Eyes - How to make them less stressful

Dry eyes are more than a modest problem.  They can be the cause of great stress.

Sufferers wake up with scratchy eyes, and have to take drops frequently just to avoid discomfort.  

 

When untreated, dry eyes are more likely to get infections or redness, and their owners are more likely to be irritable. 

Let's take a look at the problem, and consider solutions.

1. What are tears?

Tears are really a mixture of three layers over the surface of the eye; water, oil, and mucous.  The water layer is closest to the cornea, while the oil or lipid layer is secreted by the mebomian glands of the lids.  The lipid layer keeps the water from evaporating.  The mucous layer on the top is there to protect the other two layers from blasts of air and particles that might prove irritating.  The final protective layer of the eyeball is the lids, which blink to renew the spread of the three layers, and to refresh the eyeball surface.  Tears are produced inside and along the edges of the lids, and drain out through the punctum or hole in the inner margin of each of our upper and lower lids, close to the nose.  The tear ducts then carry them away into the nose.  This is why crying is also associated with blowing your nose!

2. What makes eyes go dry?

There are many factors that lead towards dry eyes.  These include staring too long at computers, tablets or cell phones, where the eyes are trying to stay open for focus and concentration.  The same can happen with prolonged study of books, or staring at the road while driving on a long trip.   LASIK surgery (to restore normal vision to people who need glasses) can also be drying in later years.  People with certain skin diseases like acne rosacea and Sjogren's syndrome may suffer from dry eyes.  Even birthdays can cause dry eyes, starting at about the age of 50.  In younger people, makeup and facial soaps can add to the problem, as can wearing contact lenses for excessive periods of time (even if the manufaturer promises you can leave contacts in overnight).  Ambient dust or other small particles can also bedevil the dryness problem.  Certain medications can also cause dryness as a side effect; be wary of drops that "remove redness" as these too can make the problem worse.

3.  What can I do about it?

Try to establish root causes.  If your room air is dusty, try to control it with air filtration or other measures.  If you wake up with dry eyes, make sure your pillow is not a bag of dust by washing or dry-cleaning it.   If makeup is a problem, use hypoallergenic products, and learn how to apply them properly.   If you stare for hours at computers, then try to take your breaks outside, and focus on distant objects to give your eyes a break from the short distance stare.  If non-prescription drops are not sufficient, please see your doctor.  While your family doctor can initiate investigations, including for general health issues, you will need to see a specialist to further examine the eye, including to measure the production of tears with a strip of litmus paper and stained eye drops.  As you will see on our post on the subject, it is important to have the full array of modern tools to examine the eye, not just a hand-held light with an eye chart at the end of the room.  Once the doctor assesses the problem, then a menu of options apply. 

 Punctal plugs can be inserted into the drain holes of each lid, commonly the lower ones.   If you have tried non-prescription drops, make sure you use them often and correctly. (see our article on Eye Drops Made Easy)   

 If the problem is with dry wax in the meibomian glands of the edges of each lid, then try to use warm compresses such as a face-cloth.

Press firmly over each eye for a minute or so, and the dry balls of wax in each gland opening will melt away.  Shampoo in the eyes, (almost!) can also be effective in dissolving the waxy gland material; use a gentle shampoo like Baby Shampoo, and rub it into each eye, almost opening the lids.  After leaving it for a minute, then rinse under the shower. 

Use regular drops like Refresh or Systane, just for lubrication and moistening. 

 

Above all, make sure you have your eyes examined regularly, and protect them with sunglasses, or appropriate goggles for handywork or sports. 

Osteoarthritis and the Cherry: The latest Joint Venture

Joint inflammation,  or “arthritis”, is very common with today’s active public.  As opposed to a disease that travels through various joints in the body, osteo-arthritis is one condition that is physical in nature.  In other words, “osteo” form of arthritis is a “wear and tear” or “rusty hinge” phenomenon, usually caused by repetitive trauma in any joint, which can vary depending on the activity in question. 

For example, runners often get this in their great toe joint, where the toe meets its metacarpal.  This form of repetitive motion is certainly aggravated by poorly fitted shoes, or by running on concrete (instead of grass or soft ground).   When this joint is inflamed by gout (a systemic condition where millions of crystals of uric acid deposit in joints and kidneys), we call it “podagara”.  Coincidentally, Sports Medicine researchers are now finding that an old-fashioned natural remedy for gout can also work wonders for any “osteo” joints in the body. 

Tart cherries have long been suggested as an anti-inflammatory aid to gout patients, as part of their treatment protocol.  But recently researchers at the Oregon Health and Science University studied twenty women between the ages of 40-70, all of whom had osteoarthritis.  Each was asked to drink tart cherry juice twice a day for three weeks.  They were tested for markers of inflammation in the blood stream.  It turns out that excellent results were seen, especially with those who had the worst inflammation to begin the study. 

Principal investigator Kerry Kuehl  M.D. of the Oregon Health and Science Universtiy, was delighted to confirm that a natural food could offer such anti-inflammatory help without any of the side effects associated with drugs.  Since most people who exercise are also health conscious, this is particularly good news for athletes, including the weekend “warriors”. 

Leslie Bonci, Director of Sports Nutrition athe University of Pennsylvania Medical Center for Sports Medicine, has incorporated tart cherries into the training menu for all of her athletes. 

The active ingredient in the cherry is the antocyanins; antioxidant compounds that reduce pain and inflammation at levels comparable to many well-known pain pills.   Available in dried, frozen and juice forms, tart cherries are versatile, and easy to find.

So if you are aching in any joint, don’t be intimidated by all the pills at the drug store.   Sometimes the best treatment can be “cherry-picked” right from your local grocery store. 

For more reading: Reduce Chronic Inflammation in People with Osteoarthritis 

And for another good way to treat pain without drugs: Acupuncture: An old treatment gets to the point!

 

 

 

Suntan Bed Dangers- the "Stupid Light" is ON

Not very long ago, society people were pale, and outdoor workers had suntans.   For whatever reason, society reversed the trend, and now it is fashionable to have a dark tan.  

Movie stars led the way.  George Hamilton was so addicted to tanning that it was written into his contracts that he could escape for weekend tanning breaks.  This led to some humorous continuity problems on set, like one movie where he jumped out of an airplane tanned, and was then seen untanned in his parachute a few seconds later!  Today, icons like Paris Hilton continue the trend.

A generation ago teens would lie out in the sun for hours, and use no protective sun lotions.  Worse, they would use baby oil, sometimes tinged with iodine to enhance absorption, in order to get a faster tan.  Lotions and oils were sold for tanning, but not for screening.

 

When Christmas/New Year's holidays came, students who went south for the sun would actually try to stay a couple of extra days, in order for their tans to last further into the new term back at school.

Then dermatologists started reporting the obvious.  Sun exposure/tanning was horrible for the skin. 

 Not just for reasons of skin cancers like melanoma, but for cosmetic reasons. The price of burned skin is premature aging.

 We are now seeing signs of permanent damage in younger adults.  Hence the rise of procedures such as chemical or laser peels, dermabrasion, injections into the face and lips, and face-lift surgeries. 

Here are a few facts that might help change your mind before sunbathing or using a suntan bed.

1. The tanning-bed suntan before a beach holiday does not protect you from sun damage.  Even with a great tan, you are fully exposed to risk when bare skin is in the sun or UV lamp light.  

2. The suntan from a bottle or spray lasts about as long as a real tan, and doesn't flake during the second week. And of course it can be reapplied at regular intervals, unlike having to take a trip to the tropics every couple of weeks. Also, the fake tan is indistinguishable from the tan gained under the sun or lamps.

3. Skin cancer (basal cell cancer, and melanoma being salient) risks are increased over 75% in those who tan before the age of 30. 

4. Tanning beds (and of course tanning in real rays) has been ranked with asbestos and cigarettes as a huge cancer risk. 

5.  In addition to dangers of cancer (to which most young tanners will feel imune), consider the cosmetic consequences.  Like splotches of discoloured skin, increased moles, permanent wrinkles on the lips and face, and even thinning and sagging of the skin.

6. If you must be out in the sun, cover up with a hat, and use a high SPF sunscreen.  Reapply as needed.  Also avoid the brightest part of the day if you have a choice; stay in the shade during the midday sun.

For additional information: Tanning Beds: what you need to know

 

For an interesting message to teens, read this link: Tannning Bed Risks

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