Test Your Balance
1. On both feet Stand with feet together, anklebones touching, and arms folded across chest; then close your eyes. Have someone time you: Though it's normal to sway a little, you should be able to stand for 60 seconds without moving your feet. Next, place one foot directly in front of the other and close your eyes. You should be able to stand for at least 38 seconds on both sides.
2. On one foot Stand on one foot and bend other knee, lifting nonsupporting foot off floor without letting it touch standing leg. (Do this in a doorway so you can grab the sides if you start to fall.) Repeat with eyes closed. People age 60 and younger can typically hold the pose for about 29 seconds with their eyes open, 21 seconds with their eyes closed. People age 61 and older: 22 seconds with eyes open, 10 seconds with eyes closed.
3. On ball of foot Stand on one foot with hands on hips, and place nonsupporting foot against inside knee of standing leg. Raise heel off floor and hold the pose—you should be able to do so for 25 seconds.
Bonus Balance Tip: Sleep more than 7 hours a night. Sleep deprivation slows reaction time, and a study at California Pacific Medical Center shows that it's also directly related to falls: Researchers tracked nearly 3,000 older women and found that those who typically slept between 5 and 7 hours each night were 40% more likely to fall than those who slept longer.
-Roset Samuel M.D. (RGMG) 523 8900 Our Physician Sponsor
(Contact her asst. Antoinette)
-Janet Acosta Clifton (MVRMC) Director of Dev. jeannette.Acosta@mountainviewregional.com) 522 0503
-Tim Peterson (Maximo Services Web Design) Our unpaid web site designer firstname.lastname@example.org
-John Gallegos Pharmacist MVRMC John.Gallegos@mountainviewregional.com) Keeps us current on cutting edge developments in osteoporosis meds.
-Dewell Hardesty PhD Exercise Physiologist Co-owner Del Valle Physical Therapy teaches bone loading, flexibility, strength training and balance exercise which are safe for those with osteopenia and osteoporosis.
-Charlotte Tallman (author, journalist) helped smooth group’s birth at MVRMC.
-Thomas Hanson MD endocrinology Classes on relationship of bones to glands such as the parathyroid glands.
Dewell Hardesty earned his Master’s in Sports Science with the United States
Sports Academy and completed his Bachelor’s degree with Western
New Mexico University in secondary education. He was an original founding
partner of Del Valle Physical Therapy & Rehabilitation in 2002.
Dewell: Weight bearing exercises (such as walking) in which the bones of the legs
bear weight of the body. Weight-bearing exercises help to encourage bones
to make new cells. (Note: see the list of weight-bearing exercises below.)
Some studies, say physical therapy works as well as surgery in many tears of the meniscus. Has that been your experience?
Dewell: The meniscus is the cartilaginous tissues that provide stability to the knee when it undergoes tension and torque It joins the bones at the knee. Some areas of the meniscus get more blood flow than others. In many cases it pays to try physical therapy before surgery. It’s also important that you maintain the fluid levels in the joint with movement.
If I get a referral from my doctor for physical therapy, how many sessions will Medicare likely pay for?
Dewell:Currently Medicare puts an upper limit of $1980. Other insurance companies put varying numbers of sessions to be covered when your doctor gives you a referral for physical therapy.
My Physical Therapist has given me a copy of exercises I do at therapy. When I complete my rehab, should I continue to do them at home?
Dewell: Absolutely you should continue to do them at home. In fact, if you are not given a list of exercises for home use, ask for one.
What is your opinion of steroid injections? Do they stop being effective after while?
Dewell: The thing is, everybody responds differently to steroid injections as well as other types of injections. The period of time that they relieve pain after application also varies widely in different people. Remember, in the case of steroids, there is also a concern for the liver with continued usage. Your doctor will probably put a limit on the number of injections you can receive yearly, usually it’s 3.
In general does medical insurance cover visits to a therapist less often than it used to?
Dewell: The factor in this is co-pays. While all or most insurance plans cover physical therapy, the co-pays are now higher. What used to be a co-pay of $250 can now be $1000 or higher.
Should people with osteoporosis of the spine avoid playing golf? I have played golf for years. If there is risk of spinal fractures with the twisting movements required, I will reluctantly give golf up.
Dewell: What everyone, including golfers, needs to know is that the 1st hour after we get up in the morning, our spines are most vulnerable because th discs are plumped up, nice and fat. Then, if the core muscles aren’t strong, bending over can cause a herniated disc. In the 1st 30 minutes after rising, the spine and therefore our height, can lose ½”. Probably it is best to wait an hour after rising to play golf, exercise, garden, etc.
Are there particular exercises and movements those with severe bone loss should never do?
Dewell: Posture. Be aware of your posture. Exercises such Tai Chi and modified yoga reinforce safe movement for those with fragile bones. A program of physical therapy will guide you in relearning proper movement, setting up a safe work space at your computer and eliminating unconscious body positions which put your spine at risk.
Do pain patches using transcutaneous electrical nerve stimulation which now being advertized on TV and widely available in drug stores do any good or would I just be wasting my money? How do they work?
Dewell: Transcutaneous Electrical Nerve Stimulations or TENS is a device that sends signals to block pain in sites where your body is hurting, for example your lower back. You will need a perscription if you want this as part of your physical therapy. You can also get them in many retail outlets. Some people swear by them. They do work for some people and not for others.
Physical therapy works as well as surgery for
some with torn knee cartilage
Patrick J. Skerrett, Former Executive Editor, Harvard Health
Tiny shock absorbers in the knee (each
one is called a meniscus) provide a key cushion between the thighbone and the shinbone. They are prone to tearing, and sometimes just
wear out. A torn meniscus can cause pain or other symptoms, like a knee that locks. But sometimes they don’t cause any symptoms.
In a youngish person, when a knee-wrenching activity like skiing, ultimate Frisbee, or slipping on the ice tears a meniscus, the damage is often repaired surgically. But a torn meniscus is often seen in the 9 million Americans with knee osteoarthritis, and for them the best course of action hasn’t been crystal clear. Results of the Meniscal Tear in Osteoarthritis Research (MeTeOR) trial published yesterday in the New England Journal of Medicine indicate that physical therapy may be just as good as surgery.
When the shock-absorbing
cartilage in the knee is torn by injury or worn ragged by use, the result is called a meniscal tear. Stiffness and a vague sensation
that the knee is not moving properly often result.
Surgeons at Harvard-affiliated Brigham and Women’s Hospital and six other large hospitals recruited 351 men and women with symptom-causing knee osteoarthritis and a meniscal tear. Half completed a six-week physical therapy program aimed at easing inflammation, strengthening muscles supporting the knee, and improving the knee’s range of motion. The other half underwent a procedure called arthroscopic partial meniscectomy, in which unstable pieces of the meniscus are removed and the remaining edges are smoothed, followed by the same physical therapy program.
Participants in both groups reported similar
improvements in knee function and pain at six and 12 months. About one-third of those who received only physical therapy “crossed
over” during the course of the trial and had surgery.“We did this trial because surgeons really haven’t been sure what’s best for
these patients,” said Dr. Jeffrey N. Katz, professor of medicine and orthopedic surgery at Harvard Medical School, who was one of
the leaders of the trial. “Now we have a better picture, and can advise people with knee osteoarthritis and a torn meniscus that physical
therapy and surgery are both good options.”
Keep in mind that the people participating in this trial had already had an MRI and
been referred to a surgeon. For most people with knee osteoarthritis and a possible meniscus tear, conservative therapy is usually
the place to start, especially when symptoms are mild, says Dr. Robert H. Shmerling, an associate professor of medicine at Harvard
Medical School and rheumatologist at Beth Israel Deaconess Medical Center.
Making the choice
In younger people, it usually takes
a strong twisting force to tear a meniscus. In people with osteoarthritis, the meniscus can tear without an injury, probably a result
of ongoing degeneration of the cartilage.
Symptoms of a torn meniscus include:
stiffness and swelling in the knee
pain and tenderness along the joint line or general knee pain
swelling in and around the knee
catching or locking of the knee
As the NEJM report points out, not all meniscal tears need to be repaired. In fact, since even a torn meniscus can function as a shock absorber, it may sometimes be a better option to support it with physical therapy than surgically removing bits of it.
Next steps for the MeTeOR team include trying to determine if certain symptoms or psychosocial characteristics or other factors can identify individuals as better candidates for physical therapy or surgery.