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Musculoskeletal Health - Springfield Clinic
 

Musculoskeletal Health - Springfield Clinic

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Protect Your Framework: Musculoskeletal Health, presented by Diane Hillard-Sembell MD, Orthopaedic Surgery, Springfield Clinic. ...

Protect Your Framework: Musculoskeletal Health, presented by Diane Hillard-Sembell MD, Orthopaedic Surgery, Springfield Clinic.

Originally presented at Springfield Clinic Me 1st Women's Health Event, May 2010 - All information and images provided by presenter.

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    Musculoskeletal Health - Springfield Clinic Musculoskeletal Health - Springfield Clinic Presentation Transcript

    • Framework: Maintaining Musculoskeletal Health Diane Hillard-Sembell, MD Orthopaedic Surgeon, Knee Specialist Springfield Clinic Medical Director, AthletiCare Sportsmedicine
    • Fitness Family/ House- hold Career Friends
      • Time is the major
      • obstacle preventing
      • women from regular
      • physical activity.
    • WHY EXERCISE?
      • Fitness is your cheapest
      • health insurance!!
    • WHY EXERCISE? Medical benefits
      • Exercise may prevent/reduce/ease:
      • Coronary artery disease
      • Stroke
      • Obesity
      • Hypertension
      • Diabetes
    • WHY EXERCISE? Medical Benefits
      • Exercise may prevent/reduce/ease:
      • High cholesterol
      • Cancer
      • Back pain
      • Arthritis
      • Osteoporosis
    •  
    • EXERCISE REDUCES STRESS! EXERCISE REDUCES STRESS!
    • Effects of aging
      • Degenerative changes
      •  flexibility
      •  strength
        • 40 to 50% loss in muscle mass between ages of 25 and 80
      •  endurance
      •  reaction time
    •  
    • Sarcopenia – No one is immune!
      • Loss of muscle tissue
        • Sarcopenia defined as 2 SD below mean of young healthy counterparts
        • 23% women, 27% men 64-92
        • If greater than 80, 31% woman, 53% men
      • Must differentiate physiology of AGING versus physiology of DISUSE!
    •  
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    • YOUNGER NEXT YEAR
      • By Chris Crowley & Henry Lodge
      • Workman Publishing
      • 2004,2005,2007
    • Harry’s Rules
      • Exercise 6 days a week
      • Do serious aerobic exercise 4X/week
      • Do serious strength training 2X/week
      • Spend less than you make
      • Quit eating crap!
      • Care
      • Connect and commit
      • Exercise for Successful Aging
      • “Skeletal muscle is the largest organ in the body and is intricately tied with protein turnover … Activating skeletal muscle has many important health benefits we are only beginning to understand.”
      • ~ Steven Blair, PhD
      • Cooper Institute for Aerobics
    • Exercise
      • Unfit forty year olds regardless of weight have higher death rates than fit 40 year olds
        • Those who become fit reduce their mortality risk by 44%
        • Each 1 min increase in time on treadmill at maximal effort associated with 8% decrease mortality
    • Stay Active, Not Just Thin To Live Longer Woman Men Fit-not fat 0% 0% Unfit-not fat 30% 25% Fit-fat 32% 44% Unfit-fat 57% 49%
    • Physiological Benefits of Exercise
      • Reduces risk of:
        • Coronary artery disease
        • Serum lipid abnormalities
        • Hypertension
        • Diabetes
        • Osteoporosis
        • Obesity
        • Colon cancer
    • Musculoskeletal Benefits of Exercise
      • Improved muscle strength
      • Increased bone mass
      • Improved joint mobility
    • Fitness starts with setting goals
      • Realistic
      • Achievable
    • Getting Started
      • Enjoyable
      • Sustainable
    • In the Bleachers
      • “I give her a week,
      • then she will be
      • back in here with
      • us and that
      • treadmill will be
      • gone in the next
      • garage sale.”
    • MYTH
      • Weight loss means I’m getting in
      • better shape.
    • MYTH
      • …”just five minutes a day, you can do
      • this on the couch watching TV…”
    • MYTH
      • Fitness is an all-or-nothing proposition.
    • MYTH
      • Metabolism can be “rev-ed up” by special
      • diet, pills, powders, or thermogenic herbs.
    • MYTH
      • Weight training will make me muscle-
      • bound.
    • FITNESS COMPONENTS
      • Cardiovascular
      • Strength
      • Flexibility
    • CARDIOVASCULAR Guidelines
      • Minimum 30 minutes aerobic exercise 3X/week (recommend 4-5X/wk)
      • 60-90% maximum heart rate
      • Target heart rate(THR)
    • A Wealth of Options
      • Personal trainer
      • Classes
      • Machines/free weights
      • Club/home
    • GETTING STARTED
      • Build physical activity into your daily routine
      • Do the same activities more often
      • Walk whenever and wherever possible
    • Getting Started (cont)
      • Start slowly with easy stretching
      • Move around frequently
      • Take the stairs instead of the elevator
      • Carry home the groceries
      • Find activities that you enjoy
      • Try out a class in your community
    •  
    • WHY STRENGTH TRAIN
      • Keep muscles and bones strong
      • Less likely to fall or to have accidents that will cause injury
      • Improve balance and posture
      • Reduce bone loss
      • Know your personal limits
    • CARDIORESPIRATORY BENEFITS
      • Cardiovascular endurance increase:
      • Requires pulse to 65-85% of max.
      • Sustained more than 10 minutes
      • At least 3x/week
      • Strength training can maintain heart rate increase as long as the interval between exercises is brief.
    • SARCOPENIA
      • Sarcopenia is the loss of muscle mass.
      • This occurs with aging.
      • Strength training rebuilds the muscle and maintains mass.
    • DAILY ACTIVITIES
      • Shopping
      • Gardening
      • House cleaning
      • Grandchildren
      • All require a minimum strength to perform effectively and safely.
    • JOINT STABILITY
      • Is increased by co-contraction of muscles around a joint.
      • Reduces joint injury with common tasks.
      • Reduces pain of arthritis.
      • Benefits from free weights.
    •  
    • RESTING METABOLIC RATE
      • Increases with greater muscle mass.
      • Burns calories.
      • Increases for some time after exercise.
    • STRENGTH TRAINING MYTHS
      • Strength training will slow you down.
      • It takes too much time.
      • If it hurts stop!
      • Muscle gains turn to fat when you stop training.
      • You will get muscle bound.
      • Increased risk of coronary artery disease.
      • Dangerous for those with high blood pressure.
      • You will look like Arnie Schwarzenegger
    • SAFETY TIPS
      • Start slowly-but challenge your muscles
      • Learn proper technique to protect your back and joints
      • Use weights that you can lift 10 times before they become too heavy
      • Breath naturally-don’t hold your breath
    • GUIDELINES - Beginner
      • 2 times per week
      • 10 repetitions of each exercise
      • 2 sets of each exercise
      • Use machines in beginning to help stabilize body
      • Strength train large muscle groups
    • GUIDELINES - Advanced
      • 4 times per week
      • 12-15 repetitions of each exercise
      • 3 sets of each exercise
      • Add free weights
      • Add small muscle groups
    •  
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    • FLEXIBILITY Guidelines
      • Slow, static(passive)
      • Minimum 30 seconds stretch for each muscle group
      • Repeat three times
    •  
    • Exercise
      • Always take time to warm up and stretch before physical activity and cool down and stretch after activity.
    • Osteoporosis
      • “ The Silent Thief”
      • Osteoporosis affects more than 25 million U.S. citizens.
      • More that 1.5 million fractures occur each year.
    • “ Fragile Bone Disease”
      • osteo = bone
      • porosis = porous
    • OSTEOPOROSIS
      • Loss of minerals, particularly calcium.
      • When 30% loss, bones break easily.
      • Bones are undergoing continual replacement, and respond to stresses
    •  
    • OSTEOPOROSIS
      • Commonly compression fracture spine. 33% up to 75%
      • Hip fracture
      • Wrist/rib fractures
      • Stress fractures (Exercise does not prevent demineralization due to estrogen lack.)
      • Controllable factors
      • Low calcium intake
      • Smoking
      • Medications
      • Alcohol
      • Caffeine
      • Lack of weight bearing exercise
      • Excessive use of antacids and laxatives
    • PEAK BONE MASS
    • Will your bones live as long as you do?
      • Bone Mineral Density (BMD)
      • Normal X-Rays cannot detect bone
      • loss until at least 30% of bone mass
      • is lost!
    • “ Weight-bearing”
      • Walking
      • running
      • aerobics
      • tennis
      • strength-training
      • Osteoporosis is NOT an inevitable part of menopause or aging.
      • Exercise has a positive effect on bone mass.
    • Treatment
      • Calcium
      • Vitamin D
      • Weight-bearing exercise
      • Medications
      • Baby Boomers 1946 to 1964
    •  
      • JOCK vs. CLOCK
    • BOOMERITIS
      • Nicholas A. DiNubile, MD
      • American Academy of Orthopaedic Surgeons
      • “ FIX-ME-ITIS”
      • Use the “10 percent rule” TWICE
    • Exercise for Arthritis Management
    •  
    • Knee Joint
      • Healthy knee joint
      Arthritic knee joint
    • Causes of Osteoarthritis
      • Genetics
      • Joint injury
      • Obesity
      • Age
      • Sex
    • Weight Loss
    • Weight Loss
      • Losing small amounts of weight can have a dramatic impact on knee OA development
        • Loss of 10 LBS. over 10 years has been shown to decrease the risk of symptomatic knee OA in women by more than 50%
      • Also-> 6.3kg loss over 6 months significantly decreased symptomatic knee pain in women >50% over IBW
    • Weight Loss
      • If we could go from:
      • Obese  overweight
      • Overweight  normal weight
        • This would prevent 33% of all knee OA in women and 20% in men
    • Treatment
    •  
      • BMI=wt(kg)/ht(m)2
      • Calories burned > Calories consumed
    •  
    •  
    •  
      • Exercise does NOT cause arthritis! In fact, physiologic loading is necessary for cartilage health.
    • Goals of Exercise Program for Arthritis
      • Preserve or restore ROM/flexibility
      • Increase muscle strength
      • Improve aerobic conditioning
    • Exercise Adaptations for People with Arthritis
      • Begin slowly and progress gradually
      • Avoid rapid or repetitive movements
      • Adapt physical activity to the individual
      ~ American College of Sportsmedicine
    • Exercise alternatives
      • Walking on concrete
        • 2-6x body weight
      • Cycling
        • equipment, safety/balance, environment
      • Running
        • 12x body weight
    •  
    •  
      • MOVE IT OR LOSE IT!
    • ATHLETIC INJURIES Female
      • Shoulder impingement
      • Hip bursitis
      • Patellar pain
      • ACL tears
    •  
    •  
    • ACL Injury: Female vs Male
      • 4-8 times higher incidence
      • Non-contact ACL injury rates higher
    •  
    •  
    • NCAA Surveillance Study
      • Arendt E, Dick R: Knee injury patterns
      • among men and women in collegiate
      • basketball and soccer. NCAA Data and
      • Review of the Literature.
      • AM J Sports Med 23:694-701, 1995
    •  
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    • Theories
      • Anatomy
      • Alignment
      • Hormonal influence
      • Training factors
    •  
    •  
      • Can we prevent the epidemic?
    • We CANNOT Control
      • ACL size
      • Notch width
      • Pelvis shape
      • Knee and foot position
    • We CAN Control
      • Strength
      • Landing mechanics
      • Muscle recruitment
    •  
    • Plyometric Training in Female Athletes
      • Decreased peak landing forces 22%
      • Decreased medial-lateral motion 50%
      • Increased hamstring muscle power 44%
      • Improved jump height
      • Hewett, 1996
    • ACL Injury Prevention
      • Neuromuscular Training Techniques
      • Strong Athletic Positioning
      • Good body control
      • Light/quiet landing dissipates force
      • Flexed “ready” position
    • Sportsmetrics© ACL Prevention
      • Dynamic Warm-up
      • Jump/Plyometric Exercises
      • Strength Training
      • Stretching
      • * Cincinnati Research & Education Foundation
    • Sportsmetrics Guidelines
      • Quality over quantity
      • Correct technique of utmost importance
      • Minimum of 6 weeks (3 x 2 wk phases)
      • 45-60 minutes per session
      • 3 times per week
    •  
    • Preventing Sports Injury
      • Be in proper physical condition
      • Get proper instruction
      • Gradual progression & cross-training
      • Warm up and cool down
      • Get adequate rest
      • Remember fuel and hydration
    • What Will 20 Years Do To You?
    • Embrace the seasons of your life!
    •  
    •