Sunday 18 March 2018

Water exercise a safe, fun option

From ljworld.com

Water exercise may be just what you are looking for to burn a few extra calories and take stress off your joints while having fun.

Are you looking for a way to jazz up your exercise routine or to start an exercise program? Whatever your age or physical condition, a water program can be tailored to your needs.
You don’t need to know how to swim to exercise in water, and you don’t have to put your head in the water. Pool exercise programs are done in the shallow end of a pool or in a pool that doesn’t have deep water.
Water exercise may be just what you are looking for to burn a few extra calories and take stress off your joints while having fun. Thanks to water’s natural resistance and buoyancy, you will get an invigorating workout that’s low-impact and less painful than doing exercises on land. This makes water exercises a good choice for pregnant women and senior citizens, as well as people with arthritis or back problems, or who are recovering after musculoskeletal surgery.
Movement in the water is helpful for people with disabilities. For example, people with arthritis or physical challenges can move muscles and joints in the water without pain, injury or fear of falling. This can be empowering for people who can’t exercise on land.
After a back, knee, hip or ankle injury — or surgery — the water’s buoyancy will assist in supporting body weight. Reducing gravitational forces in the water will make it easier to stand, walk and do strength exercises while reducing pain and decreasing the risk of injury to healing structures.
Pregnant women find water to be wonderfully relaxing. The buoyancy of the water counters the heaviness and lack of balance that comes during pregnancy. Strengthening arms, legs and lower back is vital in preparing for the upcoming bending, lifting and carrying required in the care for the new little one.
Seniors will benefit psychologically and physically from water exercise. Exercise can counter the stiffening and slowing down that comes with age. It is often difficult to take long strides, jump or hop due to physical aging.
In the water, people are less fearful about falling, feel less inhibited and learn to trust their own improved reflexes. Increased confidence in water builds increased confidence on land. Seniors who exercise are more likely to go out and do things for themselves.
And if you’d like to strengthen your leg muscles, increase endurance and improve aerobic function, why not try water running? Never mind how far or fast you go; just run in the water for half the time you would run on land. You will find your legs will get stronger, your heart will work more efficiently and you won’t end up with sore knees or feet from pounding the pavement.
Because the human body is less dense than water, we can float in water. Water offers greater resistance against body movement than air, so muscles get a workout in the water, yet there is little strain on muscles and joints because that same resistance slows down movement and reduces the effect of gravity. Muscles move, stretch and build without bearing as much weight as they would on land.
If that’s not enough to convince you to give exercising in water a try, here are some more reasons:
• Being in water is like being in an atmosphere with very little gravity. Think about scuba divers wearing weight belts to balance the buoyancy of the water. We can leap, stride and hop much farther in water than we can on land.
• Motion in the water is slower than motion on the land. Think again about the scuba diver’s slow, graceful movements. The motions performed in water are smooth and there is less risk of sudden jolting movements that can cause muscle strain or injury.
• The viscosity of the water offers greater resistance to muscle movement than air. The water is resisting the forward motion of the body. Overcoming this resistance builds strength and endurance while minimizing strains to the muscle.
• The water’s hydrostatic pressure decreases swelling in joints that often results after an injury or with many arthritic disorders.
The water pressure also improves joint position and body awareness. The hydrostatic water pressure actually is pushing down on your body, producing forces perpendicular to the body’s surface. This pressure provides positional awareness to better sense where a foot or hand is while in the water.
• The warmth of the water can be relaxing. Exercising in warm water, about 87 degrees, relaxes muscles, increases blood flow and reduces overall stiffness.
Just a final bit of caution: Some folks are not candidates for water exercise, including people with open wounds or with bowel or bladder incontinence. People who have heart disease should get clearance from their physician before starting water exercise.

http://www2.ljworld.com/news/2018/mar/18/water-exercise-safe-fun-option/


Saturday 10 March 2018

Losing Your Grip? How to Treat Your Thumb Arthritis

From clevelandclinic.org

Osteoarthritis in the thumb joint occurs more often in women


Imagine how frustrating it would be to try to open a jar or button a shirt without your thumb. This feeling is all too common for those with one of the most common types of hand osteoarthritis.
Hand osteoarthritis is second in prevalence only to knee arthritis in the United States. Osteoarthritis in the thumb joint nearest the palm — the carpometacarpal (CMC) or basal joint — is the type that most commonly causes patients to seek the care of a hand or orthopaedic surgeon. The CMC joint, which is between the thumb metacarpal and a small bone called the trapezium, allows the swivelling, pivoting and pinching needed to grip things in your hand.
Patients older than age 40 are at risk for thumb arthritis, with women affected five to 10 times more frequently than men, says orthopaedic surgeon David Shapiro, MD.
“While men and women can get basal joint arthritis, women seem to have more joint laxity, which leads to malalignment of the joint, cartilage wear, arthritis and pain, “ Dr. Shapiro says.

Losing your grip from arthritis

While your gender may predispose you to hand osteoarthritis, and in particular thumb arthritis, fractures or other injuries to the joint also may increase the likelihood of developing this condition. When osteoarthritis causes the cartilage to wear away, the shock and impact absorbing function of the cartilage is lost and the bones can rub against each other, causing stiffness and pain.
Symptoms that signal thumb arthritis include pain with activities that involve gripping or pinching, swelling and tenderness at the base of the thumb, and an aching discomfort after prolonged use. The joint also may appear enlarged or develop a bony prominence or bump over the joint, with limited motion.
An X-ray may show the severity of the osteoarthritis, but the x-ray findings do not necessarily correlate to the severity of symptoms, Dr. Shapiro says.

Timely treatment

Although thumb arthritis can be debilitating, several non-surgical treatments can ease pain and help restore function. You may benefit from icing the joint for five to 15 minutes a few times a day, other treatments you can try at home include acetaminophen or a  nonsteroidal anti-inflammatory medication, heat packs, paraffin baths, and/or topical arthritis creams.
Splints also can provide some pain relief, Dr. Shapiro says. You wear a soft splint, similar to a biking glove with a strap that stabilizes your thumb, as needed during the day. Hard plastic splints, either custom-made or off the shelf, also may help increase function and decrease pain.

Treatment beyond splints

If splinting doesn’t bring pain relief after a few months, the next phase of treatment usually involves steroid (cortisone) injections directly into the joint. While different physicians will manage this differently, one or two injections are usually worth a try, and in many cases will provide lasting relief, Dr. Shapiro says.
When nonsurgical treatment is no longer effective and the pain is overwhelming, surgery is an option.
A generally successful and rewarding procedure is ligament reconstruction and tendon interposition (LRTI) surgery. This procedure has been refined over the last 50 years, but still remains the gold standard for surgical treatment of basal joint arthritis, Dr. Shapiro says.
LRTI involves removal of the trapezium  and the use of a “spare” tendon from the forearm to stabilize the thumb. The procedure is performed on an outpatient basis. Patients usually wear a splint or cast for up to six weeks, typically followed by a course of occupational therapy.
“After removing the bone, we maintain the space with soft tissue, either with a patient’s tendon or by some other method,” Dr. Shapiro says. “LRTI provides 95 percent pain relief and about 70 percent to 80 percent return of grip strength. While complete recovery can take a while, most patients end up much more functional, and much happier after the operation than before. “

https://health.clevelandclinic.org/losing-your-grip-how-to-treat-your-thumb-arthritis/