Dr. Kyle: Can Changes in Weather Predict Pain?

 

 

I always thought my grandma was crazy when she’d say I can “feel” a storm coming as she’d rub her knees. To my surprise, her knees were often better at predicting the weather than our local news. How come?

It’s believed that changes in barometric pressure can lead to increases in musculoskeletal pain. In particular, for individuals suffering from osteoarthritis. But what’s surprising is most of the research is either inconclusive or there’s little evidence to support these claims.

After hearing a number of my patients describe similar changes in pain levels due to the changes in weather, I thought I’d take a further look at these claims.

In one survey by Von Mackensen et al., one to two thirds of patients with rheumatoid arthritis believed their symptoms were weather-sensitive (1).

Other studies found an increase in barometric pressure or a drop in ambient temperature are both associated with an increase in pain (2).

At first glance it appears there may in fact be some credible evidence to support this strange phenomenon, but why?

Joint Pain in Scuba Divers

Have you ever swam to the very bottom of a pool in the deep end and felt your ears pop? This sudden change in pressure is similar to what scuba divers experience but on a smaller scale.

Sudden changes in tissue gas tension surrounding the joints can cause fluid shifts and interference of joint lubrication. When divers go deep, their joints may hurt as there’s not as much fluid surrounding their joints. This becomes worse if severe osteoarthritis exists (3).

Why Your Joints Hurt More on Colder Days

Colder temperature and its association with increased pain is much easier to explain. We know that cold temperature reduces inflammatory markers, changes the viscosity of the fluid in our joints, and can decrease the strength and support of our muscles around joints (4). Patients tend to experience more severe joint pain during the cold winter months.

Show Me Your Search History and I’ll Diagnose Your Pain

I still recommend an in-person consultation but we’re close to this becoming a reality. A recent study found an association with local weather and rates of online searches for musculoskeletal pain symptoms.

Searches for arthritic related symptoms are significantly more common in climates closer to -5 degrees Celsius than 30 degrees Celsius. Although this doesn’t explain WHY osteoarthritic patients suffer more pain, it gives us a better idea of WHEN they experience worse symptoms and under WHAT conditions (5).

Well there you have it folks. There are still many uncertainties and unknowns on why joint pain increases when the temperature drops or pressure rises. But if you can sense the next snow storm or torrential downpour from your knees and not the news, you may be experiencing some underlying osteoarthritis.

1. Von Mackensen S, Hoeppe P, Maarouf A, Tourigny P, Nowak D.
Prevalence of weather sensitivity in Germany and Canada. Int J
Biometeorol. 2005;49(3):156-166.

2. McAlindon T, Formica M, LaValley M, Lehmer M, Kabbara K.
Effectiveness of glucosamine for symptoms of knee osteoarthritis:
results from an internet-based randomized double-blind controlled
trial. Am J Med. 2004;117(9):643-649.

3. Compression pains. In: US Navy Diving Manual. Revision 4 ed. Naval
Sea Systems Command; U.S. Government Printing. 1999:3-45.

4. Golde B. New clues into the etiology of osteoporosis: the effects of
prostaglandins (E2 and F2 alpha) on bone. Med Hypotheses. 1992;
38(2):125-131.

5. McAlindon T, Formica M, Schmid CH, Fletcher J. Changes in barometric pressure and ambient temperature influence osteoarthritis pain. The American journal of medicine. 2007 May 1;120(5):429-34.

Dr. Phil Shares: 4 Exercises for Knee Pain That Will Strengthen and Protect

4-Exercises-for-Knee-Pain

Even the fittest of us can experience knee pain during activity and exercise. If you’re feeling discouraged about getting back into shape because of knee pain, you’re not alone: The Centers for Disease Control estimates that nearly half of all North Americans will suffer from knee arthritis at some point. That includes two out of three obese Americans.

But don’t let a little discomfort push you off track. Sometimes targeting the area, gently and safely, with some basic exercises for knee pain is the best recourse—as long as you check with a doctor first.

 

Why Do Your Knees Hurt to Begin With?

Many factors can contribute to knee pain—bad posture, certain shoes, and excess pressure on the joints are all possible culprits. But there are also a number of diseases and conditions of which knee pain may be a symptom. According to chiropractor Josh Axe, D.N.M., these include—but are not limited to—chronic knee pain including rheumatic arthritis, Lyme disease, lupus, and even psoriasis. Because of this, we recommend seeing a doctor or physical therapist instead of guessing at the cause of your pain—and potentially exacerbating it.

 

How to Exercise When You Have Knee Pain

Once you’ve met with a doctor and have been cleared to exercise, the Mayo Clinic recommends the following three strategies that may help alleviate and prevent future knee pain.

  1. Strengthen the muscles around your aching joints to help brace them for the load.
  2. Maintain strength in your bones. One of the reasons why you’re in pain may be because the joints aren’t used to being exercised.
  3. Lose excess body weight, removing one potential source of stress from your joints with consistent exercise that’s safe for your knees.

Assuming you get the go-ahead from your doctor, here are some basic exercises for knee pain you can most likely do without causing discomfort or further injury.

 

Stretches for Knee Pain

Stretching, warming up and cooling down are particularly important when training through discomfort like knee pain. The American Academy of Orthopedic Surgeons has an insightful guide to stretching out the knees before a workout, including:

Basic Exercises for Knee Pain That Will Protect and Stabilize standing quad stretchSTANDING QUAD STRETCH
You’ve probably done this a zillion times without knowing the benefits: Stand up, bend your right knee so that your heel nears your right butt cheek, and grab the top of your foot. Keep knees close together, press your hip forward, and stretch the front of your hip and knee for 30-60 seconds before you switch sides.

Basic Exercises for Knee Pain That Will Protect and Stabilize hamstring stretchHAMSTRING STRETCH
Stand with your right foot extended about a foot in front of you, heel flexed upward. Hinge at the hip and bend your torso toward the right thigh. Square your hips and straighten the right leg, flexing the toes up. Aim for 30-60 seconds of stretching around the back of the knee. (These will get you ready for a more strength-oriented knee rehabilitation program too.)

 

Leg-Strengthening Exercises for Knee Pain

You might find that the mere act of daily stretching goes a long way toward soothing your achy knees. Weekly strength training will also help you to go an extra mile toward stabilizing the muscles and joints around those precious patellas.

Basic Exercises for Knee Pain That Will Protect and Stabilize half squatHALF SQUAT
For those experiencing knee pain, the half squat—going halfway down and holding the squat for five seconds—can be the best place to start.

• Stand with your feet hip- to shoulder-width apart

• Keeping your back flat and core braced, push your hips back, bend your knees, and lower your body to a comfortable depth.

• Pause for five seconds, and then push yourself back up to the starting position. Do 10-15 reps.

If it gets too easy, hold five- to 10-pound dumbbells. Three sets of 10-15 perfect squats ought to do the trick.

 


Basic Exercises for Knee Pain That Will Protect and Stabilize leg pressRESISTANCE BAND LEG PRESS
You’ll need a strong resistance band for these.

• Lie down and hook your right foot in the band like a stirrup, with the left foot extended on the floor.

• Slowly bring your right knee to your chest, fighting the resistance of the band and keeping your pelvis square, until it’s bent at 90 degrees.

• After a beat, slowly push out to full leg extension. Do 10-15 reps and switch sides for three sets.

Performing these gentle moves and soothing stretches under a doctor’s care may potentially help rehab any minor knee problems without surgery, while allowing you all the benefits of healthy exercise and continued weight loss. Once your health practitioner gives the OK, don’t quit some of your favorite workouts because they can actually help stabilize and protect your knee from pain.

Shared by Dr. Phil McAllister @ Forward Health

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Joint Pain? March 29th Seminar

Move past your pain! Complimentary seminar on Wednesday March 29th.  Dr. Laura M. Brown, ND shares some of the natural approaches to manage the inflammation that causes joint pain and what therapies may be considered to repair and reverse the damage.

Many different conditions can lead to joint pain:

  • osteoarthritis
  • rheumatoid arthritis
  • bursitis
  • gout
  • food sensitivities
  • strains and sprains

Joint Pain Educational Seminar:

Wednesday March 29th, 2017 2:30- 3:30pm 

Nature’s Signature Guelph (Seminar to be held at the Starbucks inside the Metro store at the corner of Edinburgh and Stone – 500 Edinburgh Rd. S. Guelph)

Call 519.822.8900 to Register. 

This seminar is intended for educational purposes only and does not provide individual medical advice.

 

Dr. Phil Shares: What Is the Best Workout for Those With Bad Knees?

 

person with knee pain holding

“What’s a good workout if you have bad knees?” – Martha W.

The Short Answer:
“Bad knees” is a broad term, but in general, the more you can work your knees, the stronger they will get. Unfortunately, this turns into a Catch-22 when your knees hurt during exercise. You need to exercise to relieve the pain, but the pain is caused by exercise.

The key is patience. Seek expert medical advice and follow the rehab exercises they give you. Then, when you’re ready, return to your regularly scheduled activity, following the advice of your therapist. If that activity happens to be a Beachbody program, you’ll find additional advice below.

The Long Answer:
Here’s a five-step rehabilitation plan to help with those aching knees.

Step 1 – Talk to your doctor. Some doctors, whether through laziness or fear of liability, shell out advice akin to “if it hurts, don’t do it.” Unfortunately, most of us have knee pain at some point in life. If we don’t work through it, the situation gets worse.

Regardless of your doc’s optimism, your rehabilitation begins with a diagnosis. That’s why you need a doctor. Whether your knee pain is debilitating or just nagging, it’s well worth your time to find out exactly what is going on. The alternative solution is trial and error—and that can make your knees worse.

Step 2 – Do your rehab. No matter what your problem is, your doctor will recommend some physical therapy. Like Doctors, some Therapists are better than others, but do what they say regardless. Even archaic protocols shouldn’t hurt you. A good Doctor/Therapist will just push you harder and take you further. Either way, you must do your rehabilitation before moving on. I know, it’s boring (everyone says this), but if you’re serious about fixing your knee issues you need to take this step seriously. It’s the foundation for everything else!

Step 3 – Think holistically. Most chronic knee problems don’t begin with your knee. Unless you’ve had an acute injury, most knee (and back) pain radiate from imbalances in your pelvic girdle (your hips). The simple exercises and stretches in these videos should be incorporated into your regimen as soon as you’re cleared from your PT. Hopefully, they’re similar to what you’ve been doing with your Doctor/therapist.


Step 4 – Assess your doctor’s clearance advice. This is where the steps diverge, as all knee issues are not the same. Eliminating knee pain follows a “what doesn’t kill you makes you stronger” rationale, meaning that the more you’re able to handle training-wise, the quicker and more effective your comeback will be. Along with that advice, however, is the more important logic that you don’t want to re injure your knee. That is first and foremost, and should dictate all of your actions.

For simplicity sake, we’ll use the two most-common diagnoses: 1) You are cleared for any activity, and 2) Avoid anything that puts excessive stress on your knees, like running.

Step 5, part A – If you are “cleared for any activity.” Congrats! Go start exercising! However, if you want to make sure this doesn’t happen again, I strongly recommend a round of P90X2, by far Beachbody’s most effective workout program for knee issues. It’s designed around protocols used to keep professional athletes on the field—and keeping knees healthy is the biggest challenge they face. The program targets stabilization, especially in the hip area, and building a super-solid foundation.

Whether or not you’re fit enough for X2 is a different discussion. It has an extremely modified version (hotel room modifications), so you can do the program if you aren’t super-fit, but it’s still very advanced. If you’re in reasonable shape, this would be your go-to. If you are unsure, try the P90X Fit Test, which you’ll find here. If you can handle P90X, you should be fine with P90X2.

If you can’t do the Fit Test, start with an easier program (see below). Body weight is stress for your knees, and losing extra weight will function in the same way as making your body stronger. So even if you’re cleared for anything, if you have a lot of weight to lose, pretend you’re cleared for limited activity.

Step 5, part B – If you are “cleared for limited activity.” Again, congratulations! (Sort of.) This diagnosis usually happens after an acute injury or for those who’ve ignored pain for years and lost knee cartilage. You still have the same bio mechanical goals of stabilizing your body, but you have to be more careful about how you do it.

Almost any Beachbody entry program might be right for building knee strength in this situation, depending on the severity of your condition. The rule to think on is this: Whatever you do that doesn’t make you worse, makes you better. So every time you finish a workout without pain, or pain worse than you already have (if you’re at a constant dull level of pain but still cleared to move), you’re improving your ability to eliminate the pain altogether. Also, every pound you lose is less stress on your knees, which will help lessen strain, and, thus, pain. So watch your diet, and move as much as you can. Your body will respond in kind.

Here’s a rundown and synopsis of some options to consider, from easiest to hardest.

Tai Cheng This is a great mobility and stabilization program that almost anyone can do. Downside is that it won’t burn many calories or quickly change your body composition. Upside is that, no matter who you are, it will improve your knee issues.

21 Day Fix – Currently, Beachbody’s best entry-level, knee-friendly program for those who need to lose some weight. While there is some jumping in this program, and even a “plyo” workout, there are always modifiers you can follow.

Hip Hop Abs – This predecessor to INSANITY takes jumping out of the equation, combining basic hip hop (you don’t need to know how to dance) and a lot of ab and hip work in the entry-level weight loss program.

Brazil Butt Lift – There is some light jumping, and a lot of squatting, but if you can handle it, this program focuses on your butt and hips and greatly improves the stability of your pelvic girdle. This makes your body “track” better, reducing the strain on your knees.

Body Beast – Controlled weight training is a great way to change your body composition without putting a lot of stress on your knees. If you want to lose weight, don’t follow the “bodybuilding” focus of the nutrition guide. You can both lose weight and strengthen your knees effectively pumping iron with Sagi.

PiYo – Chalene Johnson’s combination of yoga and Pilates is great for hip stability and core strength, both vital for combating knee pain, making it a good choice for those who don’t have specific ACL/MCL (or lateral) knee issues, as there is a lot of twisting at speed.

P90X3 – While it’s a hard program, you can modify every move in every workout and have it serve as an effective entry point. This program, like X2, builds a super-solid foundation. It lacks the specified stabilization movements (because it doesn’t use stability balls) but that also makes it a bit easier to adapt to.

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Dr. Phil Shares: Why The Tight Hamstrings, and What Can We Do About Them

 

Why1-do-you-have-tight-hamstrings-header

Why Do our Hamstring muscles tend to tighten up  And more importantly, exactly how do you plan to loosen them up?

Well, you may be able to sprint 100 meters in under 12 seconds, or stay on cadence in 22 Minute Hard Corps without missing a beat, but there’s one movement that will humble even the fittest of fanatics: bending at the waist and reaching for the ground.

You want your fingers to reach the floor, but frustratingly, they probably stop short around your ankles, your shins, or even your knees. One reason for this may be tight hamstrings.

First things first. “Hamstrings” refers to the three muscles on the back of your thigh: the semitendinosus, semimembranosus, and biceps femoris. Physiologically speaking, tight hamstrings refers to the anatomical shortening of the muscle belly — the center or “meat” of the muscle, explains physical therapist Rob Ziegelbaum, D.P.T., clinical director of Wall Street Physical Therapy in Manhattan.

Because the muscle belly has been shortened, there’s increased tension on the tendons, he says. This leads to less flexibility in your hamstrings, and less range of motion in the surrounding joints — the hip and the knee.

How Do Your Muscles and Tendons Shorten?

Think of them like rubber bands. Like rubber bands, tendons and muscles come with different levels of elasticity, and this is mainly thanks to genetics. “Some people are born with limited elasticity in their muscles and are, therefore, naturally less flexible,” says Ziegelbaum.

Women, incidentally, tend to be more flexible in general than men, and young children are more flexible than most adults, he says. But everyone can train to improve their flexibility as part of a well-balanced training regimen, according to the American College of Sports Medicine.

Genetically speaking, muscle length, tendon length, relative muscle and tendon length, tendon attachment points, and skeletal segment length all can play a role [in how flexible you are], says exercise physiologist Janet Hamilton, C.S.C.S., owner of Running Strong Professional Coaching in Atlanta.

All muscles and tendons have the potential to become more elastic and supple. The key to any stretching program is regularity. “For example, a gymnast who constantly does splits on a balance beam will adapt in such a way as to have relatively more flexibility than a long distance runner who works at a desk for a living,” says Hamilton.

why do you have tight hamstrings-run-impost

How Can Running Cause So Much Muscular Tension?

One of the most common culprits for tightening those hamstrings? Running. “I often see long-distance runners who gradually lose flexibility in hamstrings and calves,” says Hamilton.

Why is running so rough? Well, researchers aren’t actually entirely sure. Hamilton’s guess is that it stems from weak gluteal muscles, since the glutes and hamstrings work in synergy to propel you forward over the ground. “If one member of the team isn’t contributing as much as they should, then the other member of that team has to contribute more,” she adds. “This potentially leads to overuse and might be to blame for what we interpret as tightness.”

However, tight hamstrings and their attachments are not limited to runners. Pretty much every athlete (amateur or elite) that trains for athletic performance but doesn’t stretch thoroughly and effectively post-workout probably has tight hamstrings. “During and after a workout, our muscles tighten up in part to protect our joints and in part because of the depletion of water since dehydration tightens muscles,” Ziegelbaum says.

It’s not just the type of physical activity you do that determines how tight or loose your hamstrings will be; it’s also what you do throughout the day. “Tight hamstrings are a result of this adaptive shortening. If someone sits at a desk for prolonged periods, knees bent, hamstrings contracted, the muscle effectively changes to the required length, which is shorter than that of a person who is standing or stretching regularly,” Ziegelbaum explains.

Tight Hamstrings Often Lead to Lower Back Pain

Well, the obvious scaremongering answer is that it increases your risk of an incredibly painful partial or full tear of the hamstrings. But the bigger problem, Ziegelbaum says, isn’t actually in your hamstrings, but in those surrounding muscles.

Hamilton agrees. “Things in the human body are intricately related to one another. Movement at one segment often depends on something happening at another segment. If your hamstrings are tight, that’s going to affect the biomechanics of the two connecting joints, the knee and the hip (knee pain and tight hips). Tight hamstrings are often associated with a whole host of injuries, including various low back pain syndromes, knee injuries, and even plantar fasciitis,” Hamilton says.

why do you have tight hamstrings-stretch-inpost

In fact, a study published in the journal Foot & Ankle Specialist, researchers found found that having tight hamstrings makes you nearly nine times as likely to suffer from plantar fasciitis. Yikes!

Plus, tight hammies can actually hurt your athletic performance. “Muscles that are ‘tight’ are often weak as well,” Hamilton says. “If a muscle is weak, you’ll have to recruit more motor units to accomplish a task, which may increase fatigue… and a fatigued muscle cannot produce force as well as one that is not,” she adds.

How to Tend to Your Tight Hamstrings

You can increase your flexibility by standing up and stretching more often. Even better, upgrade to a standing desk if possible — but make sure it’s set up ergonomically or you risk adding posture problems and neck pain to your ailments, Ziegelbaum warns.

Exploring more formal and lengthy mobility work like yoga or Pilates classes is always a good idea. At the very least, though, you need to be stretching pre- and post-workout, say these experts. A dynamic (moving) stretch routine before you start sweating can help maintain muscle elasticity during the workout, and a longer stretch afterward can help counteract the activity-induced tightening, Ziegelbaum explains.

“I often encourage my athletes to do a variety of drills in their warm ups, similar to what you might see the Olympic track and field athletes doing prior to competitions: skips, hops, high-knees — anything that mimics the motion you’re about to do — but at lower intensity,” Hamilton says.

The most effective stretches otherwise? Studies from the National Institutes of Health found that active stretches (long-held postures through full range of motion) can help increase hamstring length in just 6-8 weeks.

There are dozens of safe, do-anywhere hamstring stretches in many Beachbody programs. Try them after every workout or before bedtime. Try a few after your next big workout!

Shared by Dr. Phil McAllister @ Forward Health

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