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August 29, 2010

Elderly Women with ‘Dowager’s Hump’ May Be At Higher Risk of Earlier Death

By Dr. Stacey

Elderly Women with ‘Dowager’s Hump’ May Be At Higher Risk of Earlier Death

26 May 2009  

Hyperkyphosis, or “dowager’s hump” the exaggerated forward curvature of the upper spine seen commonly in elderly women may predict earlier death in women whether or not they have vertebral osteoporosis, UCLA researchers have found.

In a study published in the May 19 issue of Annals of Internal Medicine, researchers found that older white women with both vertebral fractures and the increased spinal curvature that results in the bent-over posture characteristic of hyperkyphosis had an elevated risk for earlier death. The finding was independent of other factors that included age and underlying spinal osteoporosis.

Women who had only hyperkyphosis, without vertebral fractures, did not show an increased risk for premature death.

Hyperkyphosis can be caused by a number of factors besides osteoporosis, including habitual poor posture and degenerative diseases of the muscles and intervertebral discs.

“Just being bent forward may be an important clinical finding that should serve as a trigger to seek medical evaluation for possible spinal osteoporosis, as vertebral fractures more often than not are a silent disease,” said Dr. Deborah Kado, an associate professor of orthopedic surgery and medicine at the David Geffen School of Medicine at UCLA and the study’s primary investigator. “We demonstrated that having this age-related postural change is not a good thing. It could mean you’re likely to die sooner.”

For the study, the researchers reviewed data on 610 women, age 67 to 93, from a cohort of 9,704 participants in the Study of Osteoporotic Fractures. The participants were recruited between 1986 and 1988 in Baltimore, Md.; Minneapolis, Minn.; Portland, Ore.; and Pennsylvania’s Monongahela Valley. Researchers measured spinal curvature with a flexicurve and assessed vertebral fractures from spinal radiographs; they assessed mortality based on follow-ups averaging 13.5 years.

Adjusting for age, as well as osteoporosis-related factors such as low bone density, moderate and severe vertebral fractures, and the number of prevalent vertebral fractures, the researchers found that women with previous vertebral fractures and increasing degrees of spinal curvature were at increased mortality risk from the spinal condition, regardless of age, smoking, spinal bone-mineral density, or the number and severity of their spinal fractures.

These study findings provide evidence that it is not just vertebral fracture alone but the associated increased spinal curvature that may be most predictive of adverse health outcomes. Other studies linking hyperkyphosis to poor health, such as impaired physical function, increased fall risk, fractures and mortality, have been unable to exclude the possibility that vertebral fractures alone were the underlying explanation for the findings.

The researchers note several caveats. This study focused on women, though hyperkyphosis also affects men; measurements for vertebral fractures were based only on height ratios, which could lead to misclassification of other causes of height ratio decreases, such as Scheuermann disease; and the timing of the assessments could have affected the results, though it’s unlikely to have made much difference.

However, this study demonstrates a possible association between hyperkyphosis and increased risk for earlier death independent of the number and severity of vertebral fractures or osteoporosis in older women, the researchers write.

“These results add to the growing literature that suggests that hyperkyphosis is a clinically important finding. Because it is readily observed and is associated with ill health in older persons, hyperkyphosis should be recognized as a geriatric syndrome a ‘multifactorial health condition that occurs when the accumulated effect of impairments in multiple systems renders a person vulnerable to situational challenges.’”

Study co-authors include Arun S. Karlamangla of UCLA; Li-Yung Lui and Steven R. Cummings of the California Pacific Medical Center Research Institute; and Kristine E. Ensrud and Howard A. Fink of the University of Minnesota.

The National Institute of Arthritis and Musculoskeletal and Skin Diseases and the National Institute on Aging funded this study.

The UCLA Department of Orthopaedic Surgery provides consultation and treatment for disorders of the musculoskeletal system. Department faculty members provide comprehensive services for such specialties as joint replacement and reconstructive surgery, microvascular surgery, sports medicine, arthroscopy, foot and ankle surgery, hand surgery, pediatric orthopedics, spinal diseases, orthopedic trauma, orthopedic oncology, and metabolic bone disease. In 1998, UCLA and Los Angeles Orthopaedic Hospital formed a strategic alliance through which Orthopaedic Hospital was integrated with UCLA in the replacement facility for Santa Monica UCLA Medical Center and Orthopaedic Hospital.

Source: University of California, Los Angeles (UCLA)

Article URL: http://www.medicalnewstoday.com/articles/151328.php

Main News Category: Bones / Orthopaedics

Also Appears In:  Seniors / Aging, Women’s Health / Gynecology

Quoted from Maximized Living newsletter: http://maximizedliving.com/Home.aspx, posted to Gibsons Chiropractic on 08-28-2010

Filed under: back pain,Degeneration,Osteoporosis,Posture,Spine,Woman's Health — Tags: , , , , , , ,

July 31, 2010

CALL FOR NEW SUMMER SAFETY AWARENESS CAMPAIGN

By Dr. Stacey

Chiropractors say they can’t see any reason not to expect another busy summer holiday injury period, and are gearing up for a busy time of back, spinal and neck injuries over the next two months.

 The Chiropractors say just as Governments around Canada spend millions of dollars on road safety messages, similar campaigns should be introduced to warn Canadians about general summer safety during traditionally the busiest time of the year for holidaymakers. Hundreds of Canadians may suffer serious neck, back and spinal injuries as a result of careless or negligent behaviour at the beaches, rivers, lagoons and national parks.

 We need a general awareness campaign throughout Canada focused on general summer safety, especially in relation to beach activity, focussed not just on drowning.

 “The harsh conditions of the surf can put a strain on the spinal cord, and can pose long-term health problems if not identified and cared for properly” the chiropractic spokesperson said.

 “Parents often overlook the dangers their children face in the surf, just because they may not stray far from the waters edge. But the reality is the ‘dumping’ action of the waves at low tide is what often causes injuries, and while children readily play within two metres of the beach waterline, they are often in a dangerous region to be ‘dumped’ and injured.”

 “The most important rule for water safety is always, always check the depth first before diving or jumping into the water, even if the water is clear,” the chiropractic spokesperson said.

 Swimmers and surf goers should be mindful of surf conditions and of swimming in between the markers where the surf conditions tend to be less harsh, to help minimise risk in the surf.

 “It is similarly just as important for beach goers to minimize risk outside the surf, and to listen to their bodies when they experience small aches and pains. We see a variety of injuries ranging from simple strains and sprains to more serious injuries. Some surf injuries may initially appear minor, but unless cared for they are more than likely to re-emerge.”

 “The harsh conditions of the surf and summer water activities including water-skiing can put stress on the spine and neck, which can have long-term health implications. Just consider the pressure on your spine must withstand to swim against strong currents – not to mention the implications from a wipe-out! Spinal and neck problems can upset posture and balance, and unless cared for, your risk of re-injury increases.”

 Chiropractic helps to care for these misalignments that may have been a result of surf or water activity, and through regular checks, beach goers can help reduce the likelihood of re-injury.

 For more information on how to treat or prevent injuries, contact Dr. Stacey Rosenberg at Gibsons Chiropractic on 604-886-7080 or your family chiropractor.

[Original article source:  http://chiropractors.asn.au/]

Filed under: Head Injuries,Neck Pain,Pain,Spine,Sports,Uncategorized — Tags: , , , , ,

June 1, 2010

June is Bike Safety Month

By Dr. Stacey

Cycle Safely!

With June being Bike Safety Month, I thought I would offer a few tips on how to prevent some of the most common cycling injuries…

Start with Good Cycling Posture

Good cycling posture is very different from good posture while sitting or standing. A posture that is comfortable for sitting still will not necessarily be comfortable while actually riding a bicycle. Correct cycling posture must facilitate the pedaling action, and also must enable the rider to cope with the jolts that result from road irregularities.

Many inexperienced cyclists adopt a posture that allows their upper bodies to be supported entirely by their skeleton. This has the advantage that it requires no muscular effort, but can lead to discomfort or injury when road shocks are transmitted through the rigid bones. This discomfort may affect the back, hands, wrists, shoulders or neck.

Posture faults are primarily found in three places:

The back should be arched, like a bridge, not drooping forward between the hips and the shoulders. If the back is properly arched, spinous processes (SP’s) – the bumps you feel down your back – will cause it to flex slightly in the direction of a bit more arch; this is harmless. If you ride swaybacked, the SP’s will cause the back to bow even farther in the forward direction, which can lead to severe lumbar pain, or even serious injury.

Some back-pain sufferers modify their bicycles with extra-high handlebars so that they can sit bolt upright, with their spines straight. This is actually counterproductive in most cases, because a straight spine has no way to “give” when the bike hits rough road. Road irregularities will jam the vertebrae together, often aggravating existing back problems. The bolt-upright posture is comfortable if you’re sitting stationary on the bike, but is not suitable for riding much faster than a brisk walk. Riders who require such a position should use some form of suspension, a sprung saddle at the very least.

The elbows should be slightly bent, not straight and locked. This allows the arm muscles to act as shock absorbers.

The shoulders should be pushed forward so that the muscles in the front of the chest help carry the weight of the upper body. Many cyclists make the error of letting their upper spine dangle forward, held up by the collarbones. Rolling the shoulders forward counteracts the bending of the arms, resulting in the same general angle of the upper body as a relaxed, bone-supported posture provides, but with the resiliency of muscles providing shock absorption.

If you’ve been letting your bones do all the work, you’ll find that the muscle-supported posture is tiring at first. The harder you pedal, the more of your upper-body weight will be supported by the reaction forces to the pedaling. If you’re not used to riding this way, you’ll find that you can only sustain the muscle-supported posture for a few miles. When you tire, you’ll revert to a bone-supported posture, and problems will ensue. The answer to this is to start with rather short distances and only gradually work up to longer ones. It is true that anybody in normal health can ride a bicycle for 10 miles, but someone who is not accustomed to riding with good posture will find such a ride uncomfortable. It is better to start out with 2- or 3-mile rides and gradually increase the distance. Your ability to adopt a good posture on a given bicycle will depend on correct fitting/adjustment of the bicycle.

Occasionally, neck trouble is due to poor adjustment of a helmet, specifically, a helmet which is too far forward on the head. If the helmet is too low in front, the rider is forced to tilt the head upward to keep the helmet from blocking the view forward (poorly fitting eyeglasses that slip down your nose will also cause this problem). Sharp backward bends in the neck can cause severe problems, so make sure that your helmet is properly fitted for your riding style. Riders with a more aggressive riding position need to wear their helmets farther back than those who sit more upright.

Some Common Cycling Injuries

Wrist pain is often caused by poor upper body posture. It can also be caused by having the saddle angle too low in front: This tends to make you slide forward as you ride, and you wind up using your hands to push yourself back into position.

If the skin of your hands gets sore, cycling gloves can help a great deal. If you ride bare handed, sweat may make your hands slippery, and this can lead you to grip the bars too tightly.

Numbness of the fingers is a potentially dangerous symptom, often related to carpal tunnel syndrome. Like your bottom, the heel of your hand has two bumps, with a sort of valley between. There are important nerves that run through this valley, and it is important to avoid excessive pressure here.One common cause of excess pressure on this “valley” is riding on the top corners of drop bars in such a way that the bar presses here. If you use thick foam handlebar grips, and/or gloves with too much foam/gel padding, the “bumps” that are best able to carry weight will press through the foam, but the foam in the middle will press back at the valley. Thus, as with saddles, too much foam/gel can worsen the problem it was intended to correct!

Numbness of the hands can also be related to poor wrist positioning. Generally, the wrist should be held so that the hand is pretty much in line with the forearm. If your hand is bent upward from the forearm, the nerves can get pinched, causing numbness.

Cyclists who do longer rides in hot weather are at risk for painful chafing on the inner thighs. This is usually the result of an inappropriate saddle. A saddle that is too wide will chafe, and saddles with excessive foam/gel are also likely to cause this sort of problem. The best saddles for preventing chafing are traditional leather saddles. Wearing proper cycling shorts will help, but beware shorts with excessive padding, which can make it worse. Many cyclists find relief by generous application of cornstarch before longer rides.

Cycling, done properly, is much less stressful to the knees than many other aerobic activities, since there’s no impact involved. Nevertheless, knee injuries do occur, usually as a result of poor technique or position. A principal cause of knee problems is over-stress as the result of using too high a gear.

Another common cause of knee problems is incorrect saddle adjustment, particularly if the saddle is too low.

Some knee problems result from incorrect placement of shoe cleats. Everybody has a natural angle that each of their feet prefers to be at; when you walk or ride with plain pedals, your foot assumes this angle, and everything is fine. If you use cleated shoes and matching pedals, it is important that the cleat is adjusted so as to permit your foot to be at its natural angle. If your cleats are misadjusted, the resulting twist on your lower leg will affect the alignment of the knee joint, and cause serious problems. This is less of an issue if you ride pedals with “float” (limited rotational freedom) in the cleat attachment. Most of the newer clipless pedals offer at least some float.

Also, the longer your cranks are, the farther your knees will have to flex on each stroke. Different riders will have different amounts of flexibility in this regard, but riding with longer cranks than you are used to may definitely cause knee problems.

If you have pain in the Achilles tendons, it usually indicates a problem in pedaling technique. Achilles tendon problems often result from “ankling” (having your cleats set too far forward or otherwise pedaling with the toes) during the pedal stroke. This is occasionally related to having the saddle set too high, forcing the cyclist to point the toes excessively to reach the bottom of the pedal swing.

Ankle pain while cycling may also result from being flat-footed, in which case orthotic shoe inserts are a good remedy. Another possible cause of ankle pain is a bent pedal or crank, causing the foot to wobble back and forth as the pedals turn.

Foot discomfort is often the result of inappropriate footwear, specifically shoes with soft soles that concentrate the pedal pressure on isolated parts of the foot. It can also be related to riding in a gear that’s too high, which results in more pressure of the foot against the pedal.

Some cyclists are hypersensitive to having their feet overheat while riding. An excellent solution to this is to wear cycling sandals. Cycling sandals are a fairly new development, and most people’s initial reaction to them is “what a goofy idea.” In practice, however, they are very comfortable in warm weather. For longer rides with sandals, you should wear socks to protect against chafing.

Chiropractic Care Can Help…

If you follow these simple tips, you can enjoy safe, pain-free cycling. If you do experience pain and stress, Doctors of Chiropractic are trained and licensed to diagnose and treat problems of the spine and nervous system.

For more tips and/or information on preventing and treating cycling injuries, contact Dr. Stacey Rosenberg at Gibsons Chiropractic (604) 886-7080 or your local family chiropractor.

Filed under: back pain,Exercise,Neck Pain,Pain,Posture,Spine,Sports — Tags: , , , ,
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