Saturday, September 7, 2013

How Can I Treat Arthritis Without Surgery?


Arthritis is a combination of disorders which mainly affects the muscles along the joints. The ligaments and tendons close to the joints get inflamed and the person may suffer from extreme pain due to arthritis. Sometimes, the inflammation is severe and the people find it difficult to move the joints. The main cause for arthritis is damage to the joints which can be caused either by external injury or infection. The slippery movement of bones along the joints is hindered due to wear and tear along the joints and the person suffers from pain. Some of the symptoms of arthritis are inability to walk, feeling tiredness, weight loss, fever, muscles aches and difficulty at joints.

People suffering from arthritis are asked to manage their routine and lifestyle to prevent pain to treat arthritis without surgery. In certain cases when the patient suffers from extreme pain, it may result in a condition where you will have to go for surgery to prevent pain and but even surgery does not ensures a complete solution to the condition.

Amazingly the popular system of medicines does not provide any sure shot solution to treat arthritis without surgery. The popular system of medicine recognizes more than 100 different types of conditions in arthritis and in the popular system of medicines doctors experiment the effect of different treatments on the patient to find out which treatment could get the best solution. Many patients who are not aware of the magical properties of herbal remedies silently suffer the pain as the prescription medicines are not only too harsh on body but it also causes many chemical reactions which can further deteriorate the condition. The prescription drugs and painkiller even have severe side effects such as dullness, pain, stomach disorders, inflammation and even sleepiness and even after taking it you may not get the desired treatment for arthritis without surgery.

Alternative method helps to treat arthritis without surgery and one of the best treatments in alternative system of medicines is Rumatone Gold capsule which is time tested remedy to treat arthritis without surgery and it has proved efficiency in many cases. The remedy Rumatone Gold capsule can completely treat arthritis without surgery if it is taken properly and regularly as per the instructions given by experts. It is surprising that many people do not believe in alternative method of treatments, although, it provides a low cost cure for various chronic condition.

The herbal remedies are natural products which contain complex components prepared by nature, and when you take these remedies it provides nutrition to the body to cure the inflammation and pain. Rumatone Gold capsule and oil can give relief from pain and also help you to manage the condition. These products provide you the effect which helps to treat arthritis without surgery. These products help to improve the symptoms of arthritis and improve the overall living style of the person. These products are old remedies to cure the symptoms of different types of arthritis and it does not have any side effect.

Anterior Cruciate Ligament (ACL) Injury


When Do You Need An ACL Brace:

1. Post Injury- Just after you injure the Anterior Cruciate Ligament an ACL brace is vital to help relieve knee pain, provide needed support and protect the ligament and the rest of the joint from further damage as there is considerable time between the injury, the doctor's evaluation, the MRI and the surgery.

2. Post Surgical- Whether you have a knee scope or an ACL graft, it's important to stabilize the knee after surgery to allow proper healing, protection and if necessary to limit the amount of knee range of motion.

3. Post Healing- After you have had an ACL injury or surgery it's important to protect your knee during heavy work loads or while participating in sporting events. It's just not fun to go through it a second time!

ACL injuries are graded according to the following severity scale:

Grade I ACL Sprain (Mild ACL Sprain)

- The Injury- The ACL has only been stretched and there is no tear.

- Symptoms: mild pain, tenderness and swelling.

- Physical Effects: The knee feels stable and you are able to walk on it with little discomfort.

- ACL Brace Needed: A mild support brace that provides compression to mildly protect and help reduce swelling. View All Knee Braces

- Other helpful treatment:

Rest the knee as much as possible for 1-2 weeks and avoid strenuous sporting events or training activities.

Ice the knee for 10-15 minutes 2x/day using knee ice packs until the swelling and pain have dissipated.

Elevate: If swelling increases after activity or towards the end of the day, elevate your foot above heart level for 30 minutes.

Grade II ACL Sprain

- The Injury: The ACL has a slight tear.

- Symptoms usually include mild pain with moderate amounts of swelling about the knee.

- Physical Effects: The knee feels mildly unstable at times and may "give out" unexpectedly

- ACL Brace Needed: To protect the partial tear in the ACL it' important to wear a brace that provides moderate support and that can help keep the knee from going past it's normal range of motion because when your knee gives out, further ligament tearing may occur. View All Knee Braces

- Other helpful Grade II ACL treatment:

Resting the knee by utilizing crutches is beneficial until a doctor's visit is possible, then follow weight bearing instructions by your physician.

Ice the knee for 10-15 minutes 2x/day using knee ice packs until the swelling and pain have dissipated.

Elevate: elevate your foot above heart level for 15-30 minutes 2-3 times per day or as the swelling level demands.

Topical Analgesics: Temporarily reduces pain and discomfort and can be very worthwhile in helping get through a painful knee episode.

Grade III sprain

- The Injury: The ACL has a complete tear and needs medical attention.

- Symptoms: Pain and swelling of varying degrees from mild to intense.

- Physical Effects: The knee feels unstable or gives out intermittently.

- ACL Brace Needed: A very supportive ACL brace is necessary for this injury to protect the other sensitive tissues in the knee such as the meniscus, joint surfaces and other ligaments. This brace should be able to limit range of motion of the knee or provide complete immobilization. View All Knee Braces

- Other helpful Grade III Knee Injury treatment:

Resting the knee with crutch use is mandatory until a doctor's visit is possible, and then follow weight bearing/crutch use instructions by your physician.

Ice the knee 2x/day using knee ice packs until the swelling and pain have dissipated.
Elevate: elevate your foot above heart level for 15-30 minutes 2-3 times per day or as the swelling level demands.

Topical Analgesics: Temporarily reduces pain and discomfort and can be very worthwhile in helping get through a painful knee episode.

The anterior cruciate ligament (ACL) is the "guard dog" of the femur, tibia, and meniscus. They relate to each other in the following way:

- The femur stands atop the tibia. The two long bones could not stand for long by themselves and most certainly could not allow for movement and weight- bearing.

- The padding between the tibia bone (the lower leg bone) and the femur bone (the thigh bone) is called the menisci. Its purpose is to absorb shock as well as to protect the bones from riding one upon the other.

- The anterior cruciate ligament (ACL) helps keep the structure erect and vertical. It is much like a bungee cord or a very strong and thick rubber band that runs vertically, holding the bones and the padding (menisci) together. It provides balance, stability, and flexibility, allowing the body's "dance of resiliency" to continue.

Knee Pain Tips
Ice Packs For Knee Pain- Ice Relieves Pain Better Than Heat!
Correctly icing the knee is very effective at relieving most acute injuries and it's no different with knee pain. Whether it's an acute knee injury or chronic knee pain, knee ice packs, knee ice wraps and knee ice coolers that circulate cold water to the painful area.

Ice helps reduce pain in two ways. First it helps reduce inflammation in the tissues which in itself reduces pain, however icing also helps "numb" the area and the brain does not feel the pain over the amount of sensory cold signals.

Icing Instructions: ice the knee as needed for severe pain, but not more than 20 minutes every hour unless instructed by your doctor. Remember to always protect

Compression For Knee Pain & Swelling
Compression knee braces help relieve knee pain and reduce knee swelling by helping prevent fluid build-up. Compression knee braces are usually very comfortable and can be worn daily as needed for pain or swelling.

The information, including opinions and recommendations, contained in this article is for general educational purposes only. Such information is not intended to be a substitute for professional medical advice, diagnosis, or treatment. No one should act upon any information in this article without first seeking medical advice from a qualified medical physician with whom they have a confidential doctor/patient relationship.

Elevating the Knee
While standing inflammation and swelling tend to drain towards the feet, and if you have an injured knee, the swelling can increase when you are sitting, standing and walking. When you get your feet above the level of the heart the excess fluid can drain away from the injured area which helps to relieve pain.

Professional American Football Position Suggestions


Conditioning: Five dot jump

Conditioning is meant to increase speed, endurance, and reaction time on the football field. The intent of this drill is to increase accuracy, timing, and speed. The drill set up is a mat or place on the field with 5 dots about a foot away from each other forming an X shape, exactly in the same shape as you would see diamonds arranged on a number five card in a poker deck.

The player will start by placing a foot on the back two dots and then jumps together to the middle dot and then out separating his legs to the outer dots, much like you would see in hop scotch. Next proceed around the dots one at a time jumping with one leg only, and then change to the other leg. Then continue around the dots with both legs together. The last phase is really returning to the original starting phase of jumping together and apart, however this time the athlete will change directions after they have jumped to the outer dots. Remember that speed and accuracy are important on this drill so coaches should start players off slow and then proceed to full speed constantly watching accuracy.

Protecting the football as you run

You can't run with the football until you have learned some basic ball security measures. Nothing is worse for your offensive team then turning it over carelessly to the other team in a fumble. A great way to teach tight ball security is with four points. The claw position is the first point, meaning that you grab the football clawing at the point of the football with your fingers. The second point is making sure that your forearm is wrapped tightly on the outer rim of the football. The third point is securing the other point of the football with your bicep making sure that it is right up against it. Fourth, pull the football up and tight against your ribcage closing the gap on the football from all four sides. Practice holding the football and having defensive players try and knock out the football by any means possible. By reducing the risk of a fumble you will increase the offensive strength in effectively driving across the field and scoring touchdowns.

Open field tactics: covering ground with angle tackles

Because not every tackle is direct and head on, it is necessary to set up an angle tackling situations during practice. This can be done by having a player run with the ball on a straight line with the defender at any angle. It is great to take this in slow steps to show the defender in a fluid motion how to the quickest angle to take towards the ball carrier, plant his cleats squarely in the middle of the ball carrier, and to always remember safety and effectiveness by placing the head in front of the offensive player. The defender follows through with the tackle by straightening his knees in a lunging type motion, wrapping his arms around the ball carrier to pull him down to the ground or push him off sides.

Running Drills are a big help

Running drills are one of the most basic ways that you can enhance your endurance. Though dull and sometimes boring, these running drills will help you play your hardest until the end of the game. Even with all of these benefits you will notice that most of the complaints in practice come from running drills. Just remember that in the end it is the fastest that win games. Running has a final help to your team, and that is learning how to push beyond your limits, you will be surprised how often that happens in football, and in life.

3 Important Tips on Knee Fitness Over 50


You may have noticed that the toll of aging has been greater on some parts of your body than others. It is very common for middle age men and women to suffer from knee problems such as arthritis, tendonitis, and limited range of motion.

This is especially so for people who are unhealthy and over weight. Therefore, it is important that you begin to focus on knee exercises and fitness over 50.

The health of your knee is an important part of fitness over 40. If you are over 50, there is a greater urgency to protect and strengthen your knees.

Your knees bear your weight all day as you walk, stand up, go upstairs, and do many other basic activities. When your muscles and tendons are weak, they cannot adequately absorb shock before it reaches your knee and causes damage.

Over time, this damage can limit your knee movement and load bearing ability. Therefore, keeping your legs and knees strong is a key to maintaining independence later in life.

1) Warming up before any exercise is critical to protecting your knee. Start by walking around to stretch your thigh muscles and loosen your joints.

Next, bend your leg and slowly lift your knee up to your chest. Do this at least 10 times per knee. Finally, hold your ankle in your hand and gently pull your leg up behind your back. This will stretch out the muscles that support your knees while you exercise. Repeat this exercise at least 10 times per knee.

2) Knee exercises can be a basic or as intense as you want. Leg press and leg curl machines exercise your knees and you can add weight as you become stronger.

If you do not want to use machines you can also perform leg lifts, short-arc leg extensions, partial squats, hamstring curls, and leg swings. Make sure that you perform movements which put resistance on your knee and legs from various angles and directions. This will increase your knee support through a full range of activities. Finally, any exercise which reduces weight will benefit your knees because it will lighten the load on your joints.

An important aspect to knee fitness over 50 is to strengthen the supporting muscles in your thighs and calves. You also need to keep the tendons attached to your knee flexible.

Yoga is an excellent way to stretch and tone your muscles and tendons. A yoga instructor should be able to recommend specific movements that will benefit your knee. Also, Pilates uses your body weight as resistance and strengthens your leg muscles.

3) If you feel that your knee is especially weak, then you may want to use a knee brace. There are different types of knee braces, depending on your needs.

A basic functional knee brace should give you adequate support through most exercises. If you have a prior knee injury, your doctor may give you a rehabilitative brace to limit certain activity. Also, if you have arthritis in your knee you may find relief from an unloader brace. If you feel that you have overworked your knees, the best medicine is rest. If you notice pain, redness, or swelling you should take a couple of days off before your resume exercising.

If you continue to have discomfort, you should ask your doctor to take a look at it. Your doctor can also help you develop an exercise plan for fitness over 50 tailored to your knee. You may also decide to include a vitamin supplement to promote joint health.

The more you stretch, strengthen, and tone your legs, the healthier your knees will be. Healthy knees are critical if you want to be able to climb stairs or go for a walk with loved ones in your 70s, 80s, or later.

If you take care of your knees now, you will be able to rely on them for the rest of your life.

Develop Your MMA Game or Just Learn Self Defense By Learning Muay Thai Techniques!


Realistically there are an infinite number of Muay Thai Techniques that can't possibly be explained just in writing. Although reading about certain kickboxing techniques and how to do them will be beneficial and help you with your game, there is no substitute for practice at the gym, hitting the pads or kicking the bag.

So when reading through these basic muay thai techniques just keep in mind that you must practice these techniques and not just read about them to become competent and efficient in each and every move.

And you can't brag to your friends that you know muay thai just from reading about it, no one will respect you if you do... just keep that in mind.

First off before getting into detail about each muay thai technique, you should understand the 8 points of attack. In muay thai you have 2 fists, 2 elbows, 2 legs and 2 knees, all which are used to punch, elbow, kick and knee respectively. Easy enough right?

What should my stance look like?

If your just beginning and your unsure about how your stance should be, here's a tip... be in athletic fighting position (knees bent, hands up near your chin) and have your weaker leg slightly in front of your stronger leg about shoulder width apart.

For instance, if your a righty (orthodox stance) you should have your left leg forward... and vice versa if your a lefty.

Make sure your on the balls of your feet so your able to move freely without stumbling and expanding too much energy.

Punches

There are 4 basic punches when it comes to muay thai kick boxing... you have the jab, cross, hook and uppercut.

The Jab - is performed with your lead hand, or the one closest to your opponent. If your a righty, your jab will be with your left hand. The jab has many purposes are gauging distance, setting up a combination and frustrating your opponent, so its important to have a decent jab.

To jab you snap your arm out and keep it straight so its quick and decisive.

The Cross - is a power punch and it will be thrown with your stronger hand so naturally it will have more power behind it. A common combination to throw is a 1-2, or a jab-cross.

To throw a cross you snap your hips while extending your arm straight out towards your opponent. It's important to use your body and not just your arm when throwing your punches.

The Hook - is also a power punch and comes from the side to hopefully break your opponents guard. A common combination is the 1-2-3, or jab-cross-hook.

The hook can be thrown with your left or right, but in a fluent combination such as the 1-2-3, you usually will be alternating hands. For instance if your a righty you will jab with your left, cross with your right and then hook with your left.

When you hook your elbow is parallel to the floor so your punch is coming from a side angle and is aimed at the ear or chin of your opponent. Make sure to use your hips!

The Uppercut - is usually used when in closer range or when moving forward. It's key not to just use your arm when throwing any punch because otherwise it will lack power and not harm your opponent.

To throw an uppercut you punch vertically upwards and try to hit underneath the chin or solar plexus. It's an effective punch because it comes at a different angle from other punches and is hard to see.

Elbows

Elbows are a unique and dangerous form of attack and are one of the most essential kickboxing techniques to learn. It can be used as a glancing blow to cut your opponent or used as a power move to break your opponents nose or clock him on the chin.

Elbows are thrown in a hook, uppercut and overhand motion. So the hip movements are just like punching but your leading with your elbows rather than your fists.

Knees

Knees are great for attacking the body and doing damage while in the clinch. Just like any other punch/kick/elbow make sure your using your hips and thrusting your body into the movement.

It's important to stand up on your toes and step forward into the attack with your hands up. As you throw your knee make sure your head is back to stay away from counter punches.

Kicks

Muay Thai kicks are essential to becoming efficient at muay thai kick boxing. When you kick your power comes from your hips. Your toes are your pivot point, so make sure your up on your toes when throwing muay thai kicks. You want to land kicks with your shin not your foot.

Roundhouse - The roundhouse has 3 targets, the legs (inner and outer), the ribs, and the head. To throw kicks takes practice, especially with the weaker leg... for you have to switch your stance for a second to throw with your weak leg.

You swing your leg against the target while your hips and torso are twisted in the same direction.

Push Kick - The push kick is used almost like a jab. It keeps your opponent at bay and can knock them off balance. You lift up on your toes and use your front foot (for a quicker attack) to push at your opponents sternum.

Clinches/Throws

Unlike western boxing the clinch is one of the most important muay thai techniques to know because it is often where most of the damage is done throughout the context of a fight. While in a clinch your trying to keep your head up to stay away from knees, and at the same time trying to knee your opponent in his side of stomach.

Your able to throw your opponent to the ground as well, but not allowed to use hip throws or sweeps.

The key is to stay relaxed!

Like I said before muay thai techniques can't be learned by just reading about them, they must be learned by performing them. To become proficient at kickboxing techniques you must practice all the 8 points of attack with 100% effort 100% of the time.

Friday, September 6, 2013

Arthritis: The Cause of Joint Replacement Surgery


When searching for the main causes of joint replacement surgery, different types of arthritis come up time and again. If it's Osteoarthritis or Rheumatoid arthritis, these main types of arthritis are the leading causes for joint replacement surgery, mainly hip, knee or wrist.

Joint replacement surgery is performed when all other treatments have failed to help the patient and the pain has become intolerable, or he can no longer function normally on a daily basis. Patients reach this situation when the cartilage, which serves as a protective cushioning between two or more bones, becomes damaged and the tissues around the joint become inflamed. With time, the cartilage wears away, allowing the bones to rub against each other.

As mentioned, surgery is never the first option in case of joint arthritis. The patient will first be treated with pain medication, physiotherapy or special activity exercises. Only when these are no longer efficient, will the orthopedist bring up the surgical options.

The most common type of arthritis that leads to joint replacement surgery is Osteoarthritis. Also known as 'degenerative arthritis', osteoarthritis referrers to the degradation of the joints (mainly hip, knee, wrist and spine) and can cause them to swell up, become red, stiffen or become more tender. These symptoms usually appear gradually. Osteoarthritis is caused mainly by the aging process but can also be triggered by injury or obesity.

Another main cause for joint replacement surgery is Rheumatoid arthritis, a chronic inflammation disease. This is an auto-immune disease mainly targeting the lining of the joints. This kind of arthritis usually causes stiffness and swelling while the inflamed lining can invade and damage bone and cartilage.

It is important to know that people live with arthritis and successfully manage the main with combined types of treatments. When it comes to rheumatoid arthritis, there are even encouraging statistics showing that small numbers of patients go into remission in the first stages of the disease. However, when symptoms start affecting the patient's day-to-day life and keep him from functioning normally, it is recommended they undergoes surgery.

The term 'Joint Replacement Surgery' incorporates different types of surgery. The main types include knee and hip replacement but the term also referrers to wrist, ankle, foot, shoulder and elbow replacement surgery. The extent of your surgery will depend on the extent of the problem and severity of the arthritis.

In a hip replacement surgery, there is a total hip or partial hip replacement, also known as Hip Resurfacing, in which only part of the joint is replaced. When there is arthritis in the knee, if not severe the orthopedic may suggest a torn meniscus surgery or knee arthroscopy (relatively minor surgeries). If the arthritis is severe, a Partial Knee Replacement operation - also might be the solution. This less invasive knee replacement requires decreased healing time and is considered less painful. The total knee replacement includes the complete removal of the entire cartilage; the partial replacement removes only the damaged area of the cartilage. The rest of the joint replacement surgeries basically have similar options of partial and total joint removal and replacements.

When consulting your orthopedic specialist about surgery, it is important to not rush in to the operation without making sure you have tried all other non-surgical treatments, what type of procedure is recommended and why and how will this specific procedure help the problem.

Knee Replacement Operation


A knee replacement operation is common today. Many people have undergone this operation to help improve the quality of their lives when it has been blighted by pain and disability from a knee damaged by arthritis or injury.

Knee replacement has become much more common over the past fifteen years or so and the results patients are achieving in terms of their ability or level of function after the operation has improved as time has gone on and surgery and post operative regimes have changed.

Patients may often be advised to leave having their knee replacement until it is really necessary. By this I mean that the prostheses or the replaced joint may have a lifespan of say fifteen years on average and so if you are an active fifty year old having a knee replaced it may mean that it requires a revision of the operation before you are seventy.

Results of revisions tend not to be as successful on the whole as original surgery due to a number of factors but suffice to say that most surgeons would probably prefer not to revise a previously replaced knee if they had the choice.

People who live very active lives, for example manual workers, would do well to consider carefully the effects that having a knee replacement will have on their ability to perform their current activities. There will always be exceptions to the rule of course and there will be people around now who get on with their very busy lives after having a knee replaced and are very happy with the results.

It is advisable, as has been previously mentioned, for patients to assess carefully whether they will benefit from having a knee replacement now or whether waiting a while may be better. Obviously every patient is different and every case has to be taken on its own merits. The key question to be answered of course is WILL THE QUALITY OF LIFE BE ENHANCED BY THE OPERATION?

The operation usually involves a hospital stay of around five days. The surgery can be considered as relatively major in that it involves removing significant bone from the ends of the tibia and femur and replacing them with prosthetics to form a new knee. The new pieces have to be firmly fixed and depending on the circumstances may or may not be cemented in place.

After the operation the hard work for the patient and the therapist begins. It is very important that in the first forty eight hours after the knee replacement that the patient learns to get a good quadriceps (thigh muscle) contraction to control the knee and also makes in roads into bending it as soon as possible.

Excellent quadricep muscle action and good knee flexibility are keystone characteristics of a successful knee replacement. There is generally a marked level of discomfort associated with the activities involved in achieving these goals at least initially. The pain and resistance will gradually wear off and the activity will seem easier to perform the more it is practised. Doing well in the early stages with muscle and joint movement has an enormously positive effect on the recovery process as whole.

If progress is slow in the early stages and there is reluctance to move the new knee and work the surrounding muscles it seems to make the whole recovery process slower and more difficult. Strong and persistent effort in the first few days interspersed of course with the relevant rest seems to pay real dividends.

Performing the relevant exercise regime is done initially every couple of waking hours and then decreased in frequency but increased in intensity over the coming days to three or four times a day according the the individual circumstances.

Walking is begun soon after the two day post operative mark and is usually with the help of crutches initially. There are numerous medical reasons for this. Prevention of circulatory and muscle wasting complications among them. Patients are trained to walk as normally as possible as this aids in recovery and after six weeks the majority are able to walk well with no crutches, unless of course they are required for other reasons.

Recovery in total can take over a year. The maximal level of improvement and function will likely come in peaks and troughs and is best judged over months rather than days and weeks.

Patience is definitely necessary. Paying attention to regular movement, strength and functional rehabilitation exercise programs will over a period of time give a knee replacement that moves well, is strong and solid and allows the patient to walk well and affords a good level of function and therefore quality of life.

Foot Surgery - How to Survive With Both Your Spirits And Your Sanity Intact


It was a difficult decision, but you've decided to no longer put up with the pain, irritation, and deformity of a bunion or hammer toe. In my case, it was a severe bunion, with my big toe drifting aggressively towards my other toes, which informed my decision towards major foot surgery. My husband had undergone bunion surgery more than ten years earlier, and this trying experience, both for him as patient and myself as caregiver, had cautioned us both to plan ahead.

The devil is, indeed, in the details. Knowing that you'll be off of your feet for at least three weeks, and walking with limited mobility in a surgical shoe or boot for as long as eight weeks, takes strategic planning. It's easy to remember to gather books, DVDs, and magazines in advance of your surgery, but there's much more that can be done to make your confinement a stress-free experience.

  • Contact your doctor's office, and pick up prescriptions in advance for any medications or devices, such as crutches, that you'll need. Your doctor may also be able to sign a form for a temporary handicapped parking placard.

  • Most insurance won't cover crutches or other assistance devices until two days before your surgery. Be sure you know what your insurance will cover, and when and where you'll need to pick up materials. A rolling scooter called a knee-walker, such as a Roll-About, is a life-saver and will give you more stability than crutches. Knee-walkers may be rented at your local medical supply company, or on-line.

  • Freeze ice packs in advance. Icing, even weeks after your surgery, will help keep down foot swelling. A small cooler by your bed filled with ice packs will allow you to change them frequently right after surgery. A handy way to keep the ice packs on your foot is to secure them with a long Ace bandage.

  • Even after your stitches come out, you'll want to put a dressing on your scar to minimize irritation. Purchase gauze pads, surgical tape and stretchy "tender tape" in advance.

  • Your doctor may recommend purchasing a compression sock to minimize swelling. You can also use a tight Ace bandage or purchase an inexpensive forefoot compression sleeve at http://www.therawear.com/foot-and-lower-body-health.html?brand=120&cat=31 . Be aware that you'll also need a big, loose sock to slip over your swollen foot. My husband's wool tube socks were perfect.

  • Your foot will need to be elevated as much as possible during your entire recovery. I was given a handy foam block at the hospital. Have pillows at the ready, or purchase a foam block, about 5" in height, from a craft store.

  • Place a small table by your bedside. Have anything you may need within arm's reach, such as a water bottle, lip balm, TV remote, telephone, and medications. Another similar table or tray by your couch is useful. A 4-legged cane with a curved handle placed by the bed can act as a bed-rail, and will assist with getting in and out of bed during the first weeks after surgery.

  • Stock up on easy-to-prepare meals, such as frozen foods that can be popped in the microwave. Even after you can walk, a trip to the grocery store will be impractical. Have lots of bottled water on hand.

  • Catch up on your laundry. Laundry baskets will be hard to handle, and if your washer and dryer are located in your basement, it will be weeks until you can manage a wash. Inventory and launder casual clothes in advance, and be sure you have a few pairs of wide-legged pants that can be slipped over your surgical boot.

  • You are at your most vulnerable when bathing. Your doctor may allow you to get your foot wet as soon as a week after surgery, even with the stitches still in, so your foot will still be very tender and unable to bear weight. You'll want to have the following for a safe bathing experience:

  • Shower stool

  • Sprayer shower-head

  • Grab-bars around the tub

  • Shower gel and wash cloths (rather than soap)

  • Large plastic bags (if your doctor recommends keeping your foot dry)

  • You'll want to have a comfy, easy to slip on shoe that is close to the height of your surgical boot. Since your foot will be elevated much of the time, you'll also want a comfortable slipper for your non-surgical foot. I found that most of my shoes were the wrong height, so www.zappos.com was a convenient way to shoe-shop while confined.

  • Will you need to navigate stairs? Using crutches is dangerous - until you can walk in your boot, it's better to find an alternative method. I went up and down on my butt; my husband used construction knee-pads and went up the stair on his knees. Plan a strategy and practice in advance.

The final, and most important question, is how to keep your spirits up during a long recovery. Make a list of projects that can be done while you're home and on the couch - photos that you've meant to organize, books and movies that you've planned to catch up on, the computer game that you've never had time to learn. Gather your project supplies in advance of your surgery. Think of this time of healing not as a forced confinement, but as a period of rest and relaxation. Advanced planning will not only be easier on you, but on your caregiver as well.

Relieving Knee Pain With The Help Of A Chiropractor


In many case, chiropractic treatment can be very beneficial for those suffering with knee pain. According to chiropractors, patients seen in their offices often have problems with one or both knees. The underlying cause of this type of pain can often be cured by adjustments or manipulations given by a chiropractor. However, when the cause of knee pain is osteoarthritis, it is not curable. The associated symptoms can be somewhat eliminated. The progression of the causative disease can also be reduced with treatment. Treating knee pain is more successful if started with the initial onset. Individuals should look into chiropractic care for knee pain when:

Pain in the knee is interfering with activities of daily living.
Pain killers and adequate rest have yielded no positive improvement.
Been diagnosed with arthritis and told that nothing else can be done to help the condition.

Thorough Examination

Other anatomical structures can greatly influence the perception of pain. Often, pain is perceived to be in the knee when it is actually coming from another source. For this reason, a chiropractor will thoroughly examine the lower back, hips, pelvis, ankles, and feet before diagnosing and treating. In some cases, joints in other limbs of the body may not be working properly. This can allow for added stress on the knee joint. Over time, the added stress may result in injury. For this reason, knee pain may be resolved by treating other areas. This will also maximize the chances of long term improvement. An accurate diagnosis is necessary for treatment to be beneficial. To obtain a diagnosis, it is important that the chiropractor receives detailed and accurate information from the patient such as medical history.

Healing Treatment

Treatment by a chiropractor is individualized and modified to fit each patient's needs and other conditions. The treatment that may work for one person may not be beneficial for another. The goals of chiropractic care are basically the same and are as follows:

To reduce inflammation of the joint and alleviate pain.
Recreate normal functioning of the joint.
Promote rehabilitation with exercise regimen.
Enhance long term improvement.
Brief on Joint Inflammation

Joints that are inflamed are not only swollen and painful but often red and hot to the touch. Many factors aggravate the inflammation. Individuals should avoid activities that cause a worsening of symptoms. Elevation and OTC anti-inflammatory medications often aid in the reduction of swelling. Anti-inflammatory medicines can alleviate much of the pain as well. During chiropractic care, exercises will be introduced. As with all exercise programs, the patient will be started on a low impact program and gradually increased as tolerated. These will improve strength and stability. Properly delivered exercise also builds the endurance level of the joint. Following a daily regimen of exercise promotes the healing process and enables the patient to return to their activities of daily living more quickly. The regimen should be continued even after inflammation of the joint has subsided. A qualified chiropractor can recommend the best course of treatment for your knee pain.

Arthritis Knees: Another Disease Closely Linked to the Obesity Epidemic


Today, very few people walk well, which is particularly true of the elderly and obese. Sit on a park bench and watch the world and his wife walk by and you'll see how very badly they do it. You'll see hobblers, waddlers, mincers and strutters, but very few people who walk with elegance and grace. This is not surprising, for human gait is basically an unstable affair. Every time we take a take a step forward we have to perform the difficult task of balancing a ganging body of five feet or more on a shifting base which at times is no larger that a milk bottle top. Ideally the legs should swing easily from the hips, in a direct line with the direction of travel. But this elegant, narrow gauge way of walking can never be achieved by anyone who carries excess weight. They can't balance on one leg while they swing the other forward, so they're forced to rock and roll from side to make sure they've always got a solid base. For safety's sake, they mimic the ungainly nautical roll of a sailor on a tossing ship, just as women do in the later stages of their pregnancies. People who put on weight don't walk, they waddle.

Ergonomic studies show that a force of nearly three to six times body weight is imposed on each knee during walking. This means that a person who is just a stone overweight subjects their knees to an extra loading of sixty or more pounds with every step they take, which in time renders them prone to arthritic change because of the imperfect way their knees are used. Surveys show that if people are divided by weight into five categories, those in the heaviest group have ten times the risk of developing arthritis of their knees as those in the lightest group. This makes them prime candidates for knee replacement operations, which now take place in Britain at the rate of 77,500 a year. The same applies in America, where researchers at Harvard University have found that the percentages of cases of arthritis attributable to obesity has increased six-fold during the thirty year period from 1971-2002. That's the bad news. The good news, revealed in a recent American survey, is that if the prevalence of obesity among 50-84 year-olds could be returned to the level it was ten years ago, a total of well over 100,000 knee replacement operations would be saved. As a study carried out at the Boston University Arthritic Centre showed, women who shed just 11 lb of excess weight halve their risk of developing knee arthritis over the next ten years. Arthritic pain and stiffness in the knees is common, afflicting six out of every ten women in Britain over the age of fifty, but it's not obligatory.

Obesity increases the risk of premature death, from diseases like heart attacks, strokes and cancer. But an even greater tragedy, numerically, is that it also impairs the quality of life of countless senior citizens, whose declining years are wracked with needless invalidism and pain. For them the great misfortune is not an early demise, but what dies within them while they still live. This fate is often self-inflicted, as was shown in the case of William Banting, the English undertaker who in 1863 wrote the world's first slimming booklet Letter on Corpulence. He weighed 202lbs by the time he was 65 and was compelled to go backwards down stairs to avoid the jarring of his knees and ankles. Once he'd shed 46 lbs he was able to come down the stairs naturally with perfect ease. That remedy is available to all, so there's no reason to shelter behind the old excuse that osteoarthritis is due to 'fair wear and tear'. That fallacy is dismissed in the blog I posted on this site a few months ago which you read by asking any search engine to find 'Obesity: It's a Dog's Life and a Major Cause of Nobbly Knees.'

穢 http://www.donaldnorfolk.co.uk

How Leg, Knee and Inner Thigh Liposuction Can Sculpt Beautiful Legs


Liposuction of the legs is a particularly good solution to the problem of fatty deposits on many women's knees, inner thighs and outer thighs and even their buttocks.

By performing leg liposuction, these deposits of localized fat can be dramatically reduced to improve, and sculpt and contour the shape of the treated areas.

The technique used to remove the fat accumulations depends on exactly how much leg fat, including inner thighs, inner knees and outer thighs, there is to be removed.

Leg liposuction should not be viewed as a way to lose weight and is not for obese people. It is primarily for individuals who are pretty much at a stable weight, who exercise regularly and who eat a healthy balanced diet, but who are having a problem shifting that last very annoying area of body fat, which is particularly resistant to exercise.

There is a choice of different liposuction methods, including suction-assisted, ultrasonic-assisted and tumescent liposuction.

With the more traditional suction-assisted and with ultrasonic-assisted liposuction techniques, a general anaesthetic is preferable, but with tumescent liposuction you can choose whether or not to have a general anaesthetic as the surgeon will inject a quantity of fluid into the area to be treated. And this fluid contains an anaesthetic itself, Lidocaine.

Although, the quantity of fat to be removed and the number of areas being treated at the same time may also have a bearing on which type of anaesthetic the patient should and can have.

Before the surgery starts, the surgeon will need to mark out the areas to be treated. The patient needs to be standing for this, as fat can look very different from different angles, but generally speaking the patient is more concerned about the way it looks, from a standing position.

Leg Liposuction Procedure

The surgeon begins the leg liposuction procedure by firstly disinfecting the area and then injecting the solution of Lidocaine (anaesthetic) and vasoconstrictors (Epinephrine which prevents excessive bleeding and softens the fatty areas).

He will then, make some incisions in areas of the leg that are not overly visible, and insert the cannula or tube through which he then removes and suctions out the fat.

After this part of the procedure is complete, he sutures the incision and applies a compression pad and bandage. These incisions are not always initially sutured however, to allow for drainage.

There will be some considerable bruising and swelling immediately after the operation and this may take some time (sometimes 10 days to 2 weeks) to go down.

It is advisable that the compression garment is used for between 4 and 6 weeks but every case is individual and you would need to consult your surgeon at regular check ups after the leg liposuction procedure is complete.

Thursday, September 5, 2013

Building the Ideal Mobile Website for Healthcare Consumers


In this day and age mobile phones and smartphones in particular are the new method for communication, research, entertainment, and even shopping. If you're going to remain competitive, you have to start thinking of ways in which to attract the attention of the new aged consumer. While most hospitals have a call center and a website, chances are consumers are already on to the next thing. Mobile websites have become the thing to develop as more and more consumers look to their smartphones for viewing information online. There are about 95 million US citizens that currently use their phones to surf the web and the number will only continue to grow. This is why it is important to keep your website mobile friendly.

You might be wondering what a mobile website is. Simply put it's a traditional website that has been customized just for the use of smartphones and other mobile devices. This allows users to access, read, and navigate through the site on a smaller screen. Mobile websites are also developed using coding such as HTML/CSS, however they are typically under a different domain name. As your potential customers begin looking for your website on their mobile phones they will automatically be directed to your mobile site which is easier for use. Not having a mobile website could cause consumers to deter from visiting your site again, as it can be pretty difficult for them to interact with the large information that is on your site.

Other than the peaked interest of consumers, there are other benefits to having a mobile websites listed below:

  1. With a mobile website there will be no need for your customers to search through a 3rd party app store to access your site. Your site is very simple to find as they only need to type in the link. This makes your site available on demand which means less hassle for your potential consumers.

  2. Having a mobile website gives access to everyone with a mobile device. Your site is not specifically catered to simply one brand of phone or device, which is great for consumers who have more than one device in which they use for internet surfing.

  3. Mobile marketing has become a big thing for many businesses. Having the ability to send information to your current and potential consumers is something that no business owner wants to pass up. Your consumers are able to view your mobile advertising and access information on your website instantly.

  4. You are able to make a one stop shop for your consumers. Your mobile website can be easily linked to other web apps and directories, meaning you can offer your consumers features such as a symptom checker that your healthcare consumes would love..

  5. Many businesses are not aware that it is less expensive to maintain a mobile website than it would be to include apps that will rely on app stores.

  6. Mobile websites are the new innovative thing of the future. As mobile companies continue to create comprehensive phones that allow for people to utilize the internet on the go, companies need to continue to renovate to the next level.

There are some common things that you should remember to keep in mind when creating your mobile websites:

  • Make sure that your content is simple. Less is more, since your mobile consumers will be using their phones you have to accommodate their small screens.

  • Make your calls to action your focal point. Figure out what it is you want your audience to do. Whether that's come to your business for medical attention, or get updated information on healthcare in America, you need to make this the main focus.

  • Make sure you have click to call options for consumers. While they are visiting a mobile website you still want to give them the option to call you if they are in need of help.

It is wise to start building your mobile website now. Everyday that you waste could be another day in which consumers are using other businesses because they are accommodating their needs.

Arthritis Ayurveda Management


Ayurveda suggest that the pain is caused by Vata, one among the three somatic humors. The function of vata in the body is mobility, circulation, respiration etc. So if this is vitiated, it will damage our locomotion. The important disease causing mobile problems is Arthritis, which is caused due to the aggravation of Vata.Ama - a toxic by-product of improper digestion, also play a co actor for arthritis. This ama circulates in the whole body and deposits or gets collected at the sites which are weaker. When it deposits in the joints and at the same time there is aggravation of vata, it results in arthritis. So the treatment of the arthritis should be aimed in pacifying vata and removing ama.

Remedies: As described above ama and vata are the main causes, so efforts should be made to digest ama and to reduce the vata. This can be achieved by diet, exercises and medicine. The digestion should be improved so that no further ama is produced. For this utmost care should be given to light the fire inside the body. Efforts should be made to relieve the pain and inflammation. This is the line of treatment according to Ayurveda. Fasting is very beneficial for digesting the ama. The fasting should be complete or partial depending on the strength of the person, season and place. After the fasting, the person should return to his normal diet slowly through different steps. First he has to use full liquid foods to semi solid to solid food. Two tea spoons of lemon juice mixed in 250 ml. of warm water and a tea spoon of honey is good to take twice a day -morning and evening.

Body massage with sesame or mustard oil or any Ayurveda herbal oils like Dhanwantharam oil, Murivenna etc helps to reduce the vata and thus reduce the pain. Other useful oils are Myaxyl, Rymanyl, Rhue and Arthrum.The joints affected by pain can be massaged for longer time till the pain reduces.

Light exercise is useful but you must know your limits. Exercises without giving weight are good. For example bending the knees in lying position or at a height is good for Osteo Arthritis of Knee. As a general rule if any exercise, including walking, causes pain after one hour, you have crossed your limit.

Liberal intake of orange juice or sweet limejuice or gooseberry enhances the efficacy of any anti rheumatic drug, since Vitamin C can reduce skeletal pain. Guggul is a very helpful herb for curing arthritis. It can be taken in one to 3 gm dose twice a day after meals with warm water. The capsule form of Guggul is now available in our store. Rumalaya Forte tablet, Cervilon, Osteolief and Arjith forte capsules contain Guggul.

Contra-indications: Not recommended for people with kidney disease or acute rashes. Strict vegetarian diet should be followed.

Ayurveda panchkarma therapies are very good for managing chronic and acute arthritis. Vasti, Kizhi, Dhara etc are very good for different types of arthritis. The physician will select the choice after a thorough consultation. Kerala in India is the best place for this treatment.

Diet and Regimen: Foods which are easily digestible and do not make gas are good. Most of the non vegetarian meat stuffs are not good. Mutton is prescribed in certain conditions. Vegetable juices and soups are good. Juices of carrot, beat root and cucumber mixed together are also beneficial. Green salad with a dressing of lemon juice and a little salt is also good. Fruits like apples, oranges, grapes and papaya can be taken. Cooked vegetables like squash, zucchini and pumpkin are good.

Cooking with spices like cumin, coriander, ginger, asafetida, garlic, fennel and turmeric is also helps a lot. Avoid eating hot, spicy and fried foods, sweets, gas forming foods like cabbage, cauliflower, spinach, broccoli, okra and potatoes.

Avoid taking too much tea, coffee, alcohol, white sugar, yogurt, chocolate, cocoa and excessive smoking Sleeping during day time, staying up late in the night and mental tensions like worry, anxiety, fear, stress and grief etc., should be given up.

Regular physical exercise and every day massage with oil should form an important part of life style. Yoga and meditation will help to overcome the stress and strain.

Dr Rajesh Nair is a Web writer and ayurvedic researcher. Check out his favorite sources for ayurvedic medicines

You may freely reprint this article on your website or in your newsletter provided this courtesy notice, author name and URL remain intact.

How to Effectively Treat Knee Arthritis Without Surgery


There are millions of Americans walking around right now with arthritis in either one or both knees. Just because a person has arthritis does not mean pain will be present, but if it is bothersome what are the best ways to treat it?

Surgery for arthritis of the knee consisting of a joint replacement with an orthopedic surgeon is definitely a last resort. Artificial knee implants are not meant to last forever, and having one may last for 10 to 20 years before it needs a revision. In addition, a recent study performed at multiple VA hospitals throughout the country showed that knee arthroscopy for osteoarthritis were not as great as we once thought for pain management.

Here are 5 methods of treating the arthritis nonoperatively which can help tremendously.

1. Activity avoidance. When arthritis develops, significant stresses through the knee can be very painful either during the activity or for days afterwards. For instance, if you have been an avid jogger for many years, there may come a time where it causes too much pain in your knee which will affect your ability to exercise any walk. If this is the case, the best course of action is to avoid jogging and to switch exercises to something less stressful on the knees such as swimming for biking. That way you still continue to get the muscular and cardiovascular benefits of the activity but without the significant pounding stresses through the area of arthritis.

2. Over-the-counter pain medications- these may become simply a fact of life for individuals with arthritis. When taken properly according to the manufacturer recommendations, anti-inflammatory medications such as ibuprofen and naproxen along with Tylenol can deliver exceptional pain relief for arthritis. It is well-known that there is an inflammatory component to arthritis, so that may explain the beneficial effects of the anti-inflammatories. Narcotic medications for knee arthritis on a chronic basis is a bad idea. However, if taken for an acute flareup they may not be an issue.

3. Physical therapy- one of the well-known methods that has been proven to work well in research studies is physical therapy. This can strengthen the muscles around the arthritic knee and take some pressure off of the arthritic regions. This may allow patients the ability to walk more often, and participate in more recreational activities.

4. Injections- injections of steroids medication do not fix arthritis, and there is some animal research which shows that it may make the arthritis worse by deteriorating cartilage. But if a patient is heading towards a knee replacement anyway, then the injection may prolong the need for surgery and give months of pain relief. They can be repeated every few months. There also some injections of hyaluronic acid which is a large component of synovial fluid anyway. These injections have actually shown significant benefits in a patient's arthritic knee. One of the major studies for the treatment showed 65% good to excellent results at the one-year point.

5. Off loader bracing- knee bracing can work really well to alleviate pain. In the knee, arthritis is commonly affecting one compartment out of the 3 compartments of the knee. Because of this, the knee brace acts to offload that arthritic compartment and may be able to non-operatively relieve a patient's pain. These braces can be a little bit cumbersome but if it can avoid the need for surgery than often times these slight cumbersome nature of the brace is well tolerated compared with the pain relief that is achieved by them.

As mentioned, a knee replacement with an orthopedic surgeon for arthritis is a last resort. Most of these surgeries have excellent outcomes, but they do not last forever so the surgery should be put off as much as possible with these types of treatments.

Kettlebell Jerks - 1 Super Sick Body Hardening Drill For Fighters!


As a fighter you understand the necessity for power and endurance. These are two traits that you can't do without when it comes down to getting in the ring to knock someone's head off, or to execute a submission. As a fighter you have to have the physical prowess of both power and endurance and this is why I am here to talk to you about kettlebell jerks.

Body Hardening Exercises For Fighters!

Kettlebell jerks are a great way for you to condition your body in order to jump into the ring. This particular lift has several variations, but for the sake of this article I will only discuss one. The short cycle jerk is an amazing lift for you to achieve a super powerful core, a strong back, powerful shoulders, and the cardio to maintain a high level of intensity for minutes on end which is essential in or out of the ring!

So what is the short cycle jerk? Well, in order to pull this lift off you will need the availability of at least a single kettlebell of moderate resistance to start. For beginners make sure to practice with a lighter bell before moving on to a heavy one. The short cycle begins with you standing with your feet at about shoulder width distance apart in length. From here you are going to properly clean and rack the bell at your chest and then follow up with a series of jerk presses. The short cycle only involves a single clean and then is followed up with a series of jerks, unlike the long cycle variation which involves a clean or swing clean movement between each and every jerk press.

In order to perform the jerk you are going to execute a "knee dip" by actually flexing at the knees first as you roll up onto the balls of your feet. Here there is only a mild flexion of the hip to start. As you roll up onto the balls of your feet you are going to simultaneously start to raise the bell above your head with it's building momentum. As the bell rises make sure to fully roll up onto the balls of your feet and simply press your heels down flat on the ground to push your body "away" from the kettlebell that is rising overhead. From here all you have to do is stand up to lock out with the bell above your head. This is a terrific body hardening drill for both MMA and other athletes to ready themselves for competition.

If you haven't already started to implement the kettlebell jerks into your fighting strength program then your program is lacking my friend. Get ahead of your competition by accessing more of my articles on the subject for free. Remember that any fighter can train hard, but only the champions train smart!

What Causes Arthritis?


It can sometimes be a mystery. You speak to people in their thirties who are suffering from arthritis but others in the seventies are happily going about their business without the inconvenience of this condition. So exactly what causes arthritis?

First of all we have to be clear about what type of arthritis we are talking about because there are several different types with different symptoms. We'll concentrate on osteoarthritis as this is the most common condition and most people will know somebody who suffers from it to a greater or lesser degree.

Doctors do not know the precise causes but they are able to identify a number of risk factors for getting the condition. Here are some of those factors:

Age - We are more likely to suffer from arthritis the older we get. The cartilage that protects the ends of the bones in a joint becomes thinner in sufferers and less able to repair itself. The condition is sometimes referred to as a 'wear and tear' disease.

Injury - It has been found that osteoarthritis can develop in joints that have been previously affected by injury. But just because you have had a broken bone or other injury it doesn't mean that you are going to get arthritis in later life.

Weight - being overweight can put more stress on the weight-bearing joints of the body such as the knees and hips. These are frequently affected by arthritis and many doctors would recommend that overweight sufferers try to lose some weight if possible

Sport - There is a paradox here. Playing sport can have many beneficial effects to us all, including people with arthritis. But high impact sport at a professional level has also been implicated as a possible cause of arthritis. The twisting motion on the knee in sports like soccer, or the constant pounding of the jogger running 50 miles a week could be a contributory factor in developing arthritis. Less intense activities such as swimming are less likely to cause such problems.

Occupation - The occupation that you have performed for years may also be telling. Physical jobs such as building site laborers are more at risk. Assembly line workers who perform repetitive tasks can also be more likely to suffer.

Although it is not always possible to exactly pinpoint the causes of arthritis, it is useful to know the risk factors so that we can take action to reduce the risk of getting the disease.

ACL Pain, Diagnosis, and Treatment - Should I See and Orthopedic Surgeon?


The Anterior Cruciate Ligament or ACL, lies deep within the knee joint, connecting the thigh bone with the shin bone. Its function is to prevent excessive forward movement of the shin in relation to the thigh and also to prevent excessive rotation at the knee joint.

The ACL can be injured in several different ways, most notably by landing from a jump onto a bent knee then twisting, or landing on a knee that is over-extended. In collision sports, direct contact of the knee from opponents can cause damage to the ACL. Because of the amount of force that is required to damage the ACL it is not uncommon for other structures within the knee such as the meniscus or medial ligament to also be damaged and could require a professional diagnosis.

A moderate impact against the inner side of the knee joint causes the Lateral Collateral Ligament to rupture. A more violent impact causes the Anterior Cruciate Ligament to also rupture. In severe cases the Posterior Cruciate Ligament ruptures.

ACL injuries have been reported to occur more often now than ever before, which may be due to the increased intensity of sporting activity. In soccer, it is reported that for every 1000 hours of soccer played (training and matches) there are between 4 and 7 ACL injuries. Many high profile professional players have suffered this injury including Paul Gascoigne, Alan Shearer, Gustavo Poyet, Roy Keane and Ruud Van Nistelroy.

Signs & Symptoms
At the moment of injury the person may experience a snapping sensation deep within the knee. There will be pain, proportional to the force and degree of damage to other structures within the knee joint. In some cases the person may feel able to continue playing, but as soon as the ligament is put under strain during sports activity, the knee joint will become unstable. A classic example of this was Paul Gascoigne during the 1991 FA Cup Final, who attempted to continue playing before being stretchered off.

The reason the person is unable to carry on is that the restraining function of the ACL is absent and there is excessive rotation and forward movement of the shin in relation to the thigh. After a couple of hours the knee joint will become painfully swollen due to what is called a haemarthrosis - bleeding within the joint. This swelling provides a protective function by not allowing the person to use their knee.

Treatment
During the acute stage of the injury (the first 48-72 hours) exact diagnosis is very difficult due to the gross swelling around the joint. Once the initial treatment to decrease the swelling has taken affect the clinical diagnosis may be possible. This may be achieved by the medical personnel performing stress tests on the knee ligaments - the degree of laxity within the joint will allow the clinician to estimate the degree of damage. If there is any doubt, or to confirm the clinical tests, the patient is sent for further investigations. Most commonly an MRI scan is used to ascertain the level of knee injury. In some cases the MRI scan may not give a clear picture of the damage and it may be necessary to survey the joint with an arthroscope. The combination of these findings allows the orthopaedic consultant to build a picture of the extent of the damage.

The treatment of the ACL injury is dependent upon the amount of damage and the subsequent functional impairment, the age of the patient and the level of sporting activity. If the diagnostic investigations reveal only a partial tear of some of the fibres of the ACL, and there is minimal instability, then a conservative approach with a physiotherapist is usually indicated. This option is also more likely for adolescents and more sedentary individuals. In the case of individuals who are involved in a high level of sport where a degree of instability is functionally unacceptable, surgical reconstruction of the ligament is the surest way to restore normal function.

Surgery to reconstruct the ACL has evolved beyond recognition since the first ACL repair in 1963. By 1980, Cambridge surgeon David Dandy had begun using an arthroscopic technique. Development has continued since then and the latest surgical technique is an arthroscopic procedure where a strip of the patella tendon from the patient's knee is removed and used as a graft to replace the ACL.

In addition to advances in the surgical procedure, there have been advances in post-operative rehabilitation that have seen a return to full activity in most cases in less than six months.

Wednesday, September 4, 2013

10 Things Your HMO Won't Tell You!


So, you're thinking about purchasing, or you currently have, an HMO health insurance plan. You read the nice brochure and the coverage looks like just what you've been looking for. They tell you great things up front, and show you pretty color pictures of happy people using their plan. So what could be wrong? Why not purchase their plan? There are a number of things that they tell you that are 1/2 truths, and the most important things they won't tell you at all. If you already have an HMO, compare the 10 points below to how you have been treated with your plan. It should help make sense of it all. If you are thinking of purchasing one, beware.

1. "The less your doctor sees you, the more he earns." - One of the great things about joining a health maintenance organization is the convenience. You visit the doctor, the HMO pays for it. Most of the time there isn't a single form you fill out. But how is your HMO doctor really getting paid? You might be surprised.

Sixty percent of all managed-care plans, including HMO's and preferred provider organizations, now pay their primary-care doctors through some sort of "capitation" system, according to the Physician Payment Review Commission in Washington, D.C. This is, rather than simply pay any bill presented to them by your doctor, most HMOs pay their physicians a set amount every month- a fee for including you among their patients. At Chicago's GIA Primary Care Network, for instance, physicians get $8.43 each month for every male patient between the ages of 25 and 44, and $10.09 for every female patient between the ages of 20 and 24.

You could argue that these capitation programs are an incentive to keep you healthy: Even if you don't need your doctor, he or she gets paid. But what you need to look out for are the additional financial incentives that come with some capitated payment systems. Some HMOs, such as Oxford Health Plans, Cigna and Aetna, have "withhold" Systems, in which a percentage of the doctors' monthly fees are withheld and then reimbursed if they keep their referral rates low enough. Others, like U.S. Healthcare, pay bonuses for low referral rates. Still others, such as Health Net, have so-called risk pools, whereby primary doctors get a lump sum on top their capitation rate to pay for any patent test or specialist referrals. Anything left over is their bonus. "Capitation is the strongest reason not to recommend a patient to specialist," contends Carolyn Clancy, director of the Center for Primary Care Research at Agency for Health Care Policy and Research in Rockville, Md.

The pressure to avoid specialist can be considerable, says Dr. Lee fisher, a family physician in West Plan Beach, Fla. When he was with CareFlorida, a regional HMO, it was withholding 20 percent of his pay every month, coughing up the money only if he kept referrals low or didn't order too many test or X-rays. Ultimately, Fischer decided to drop out of HMOs altogether. "We were devoting more and more time to a small pool of patients, and we weren't getting paid very much for it, " he says. A spokesman says that when CareFlorida merged with Foundation Health in 1994, it overhauled its capitation system. "It's likely that he would not have this same issue if he were contracting with CareFlorida today," the spokesman claims.

2. "Your primary-care doctor is your specialist." - Everybody wants a doctor who's versatile, but sometimes, in their effort to rein in cost, HMOs really overdo it. How? By pushing their primary-care doctor to take on the additional duties of being a specialist. "Specialist immediately attack a problem with expensive procedures," says David Scroggins, a medical=industry management consultant with Clayton L. Scroggins Associates. "Consequently, HMOs put in the primary care physician's contract a broader scope of responsibilities."

Dr. David Himmelstein, a Boston-area primary care physician, has seen these contracts time and time again. "It's typically vague, you're-responsible-for-everything type of language, " he says. Some are even set up to reduce a doctors monthly pay if he refers you outside for work that was "reasonably available" in his own office, says Scoggins.

The result is that you'll have primary-care physicians either doing procedures for which they're not adequately trained or, more commonly, just cutting corners. They'll do a flexible sigmoidoscopy-in-serting a tube for a colon-cancer check-instead of referring you to a gastroenterologist. Or maybe they'll aggressively prescribe antibiotics for ear or sinus infections instead of sending you to an ear, nose and throat specialist. What can you do? Speak up. If you don't pester your primary-care doctor for specialist referrals, you may never get them.

3. "Your health is a numbers game to us." - Everybody knows HMOs have guidelines for the types of treatment they'll allow and the length of care you're entitled to. That's how they keep their cost down. But did you ever wonder where most of them get those guidelines? Actuaries.

That's right: Number crunchers at actuarial firms such as Milliman & Robertson collect historical care data and perform outcome studies on different procedures and lengths of stay. Then they provide the information to HMOs to be used industry standards. So never mind how you're feeling. If you've had a Caesarean section, according to Milliman, you should leave the hospital within 48 hours. You've had a stroke? You're typically headed home within three days, even if you can't walk out on your own.

It sound more than a little cold, well, that's because it is. "There's no scientific basis" for actuarial guidelines, says Carolyn Clancy. "Any guidelines are based on someone's 'expert opinion,' and that may come from a variety of perspectives."

And make no mistake: These guidelines are strictly enforced. Lee Wesner, an electronics-manufacturing manager with Comsat, had a pinched nerve and needed back surgery. The condition was so bad that he was losing the use of his foot and was actually dragging it. Delaying an operation could cause "serious damage" said his orthopedic specialist, Dr. Neil Kahanovitz, who asked Wesner's health plan, Jefferson Pilot, to approve the surgery. Kahanovitz was told that the condition had only persisted for four weeks and that Wesner had to wait the recommended six weeks.

"The denial was based on a nontreating physician's interpretation of guidelines," Kahanovitz contends. The other doctor "Failed to appreciate that the guidelines were designed to be used as exactly that, i.e., guidelines for proper, timely and appropriate care." Kahanovitz later performed the operation and Wesner recovered. Still, the surgeon says; "my patient needlessly suffered for two more weeks." A Jefferson-Pilot spokesman responds that the company looks at each case individually and that it considers its guidelines appropriate.

4. "Our exclusions could kill you." - Willing to try an experimental medical procedure? If you're in an HMO, good luck. Many not only frown on experimental or non-FDA procedures, they strictly forbid them. Take bone-marrow transplants. "In general they're performed for leukemia patients," says Dr. Martin Malawer, a Washington, D.C., orthopedic oncology surgeon. "But for the last 10 years they've also been proven to be effective treatment for breast cancer, although it's not an FDA-approved treatment." Because of this, many HMOs he deals with won't pay for it. Malawer thinks the logic is flawed. "Standards of care developed over time, and these HMOs are impeding such developments." He says. By all means, you should spend a few minutes scanning the fine print of your enrollee contract. That's where your HMO's rules about these procedures are spelled out. Chances are your contract will also explain that the policy covers only "medically necessary" treatments.

Unfortunately, that phase is wide open to interpretation, notes Dr. Laura Sudarsky, a plastic surgeon practicing in New City, N.Y. She recently saw an asthmatic patient whose Oxford Health Plans primary-care physician recommended breast-reduction surgery. It's not uncommon for asthmatics to have breast reductions-it alleviates some of the weight on the chest wall- but before Sudarsky could operate, the HMO denied the procedure. "Oxford said it did not meet their criteria for reconstructive surgery, "Sudarsky says. Tom Travers, vise president of health xcare delivery at Oxford, declines to comment on that case specifically. However, he adds, "There's no little black box into which we're putting health care and coming out with 20-30 percent savings. It's got to come from squeezing unnecessary services out of the health care dollar."

5. You're not sick until we say you're sick." - Most HMOs Demand Pre-approval for just about any care you get. For just about any care you get, whether it's simple referral to see a specialist or an emergency. Why? "It's clear that the approval process is a hurdle to reduce procedures and referrals," says David Himmelstein. "It's not the turndown that's the issue. It's the hassle it makes for the doctors."

Eric Jung, a Bellcore computer programmer, knows this firsthand. Last summer, he was on his way back to New Jersey from Rhode Island when disaster struck. After stopping to eat, he was overcome with sudden and extreme diarrhea. " I realized I wasn't going to make it home," he says. "Then I realized I wasn't going to make it to the bathroom." After the initial onslaught, he says, he passed out by the side of the road and, delirious, he was taken by his girlfriend to an emergency room in Summir, N.J.

Jung thought he followed all the claim-filling rules of his HMO, PruCare: He called his primary doctor within 24 hours of his ER visit and left a detailed message. Yet a month later, he got a $541 bill from the hospital and one for $259 from the doctor, saying that PruCare had denied it. The HMO's explanation: The emergency-room visit hadn't been pre-authorized.

In the end, Jung got reimbursed for the hospital charges. But it took five months of phone calls and letters, and, as of mid-January, there was still some dispute as to whether PruCare had followed through on its promise to finally pay the doctor's bill. Responds Kevin Heine, a spokesman for Prucare: "When he field his appeal, PruCare said they would notify him of the decision. In early December, he was informed that the facility portion would be taken care of and that PruCare was still examining the doctor portion of the bill. Would we have liked this process to have been quicker? The answer is yes."

6. "Your ignorance is our bliss." - Managed-care providers are all too happy to tell you about some things, like their coverage on well-baby care or their $125 reimbursement for new eyeglasses. But for the most part, they treat the really important information like a state secret.

How many patients have dropped out of their plan in the past year? Are doctors paid on a capitation system? How good are the doctors? We ask these questions of six different HMOs and only two - United Healthcare and Oxford- could provide any answers. "You would like to know that you percentages for surviving a heart attack, based on all the variables, are better with one plan that another," says Robert Krughoff, president of the advocacy group Consumers' checkbook. "This is exactly the kind of comparison shopping you won't be able to do among plans."

About the only place for general information on HMOs right now is the National Committee for Quality Assurance. This Washington, D.C., managed-care-industry watchdog collects various performance data on HMOs and provides it to employers. The group, which is just beginning to market its information to consumers, also runs a reasonably helpful World Wide Web sire (http;//www.nega.org), where you can look up when your HMO was last audited and whether it has the NCQA seal of approval. But it pretty much ends there. Want to see your HMO's actual performance data? Sorry, that's not available to the public. Another negative: Only about half of all HMOs have volunteered fro an NCQA audit so far. "It's an evolving field, and it's very young," concedes Barry Scholl, an NCQA spokesman. "I mean, it's embryonic."

7. "We're loose with the facts." - You call your HMO's toll-free number and get a cheerful-sounding representative who answers you claim question promptly and with authority. But when you do what she suggests, the HMO denies your claim.

Sound familiar? It happens all the time. A recent study of HMOs by the New York City public advocate found that the companies; telephone representatives often gave out badly misleading advice. Five of the 12 HMOs surveyed, for instance, claimed that all of their physicians were board-certified, an exaggeration of up to 25 percent. When a customer-service representative at one HMO was asked if she understood what board-certified meant, she replied, "It means they graduated from medical school." (In fact, it means the doctor has completed a period of post medical-school training and passed an exam in his or her specialty.)

The study pointed out at number of other problems. Representatives gave inconsistent information about the number of allowable specialist visits for instance. And they gave out wrong advice about how soon you have to notify the HMO after an emergency.

Robert Krughoff, for one, wasn't terribly surprised by the study's findings. His group has done its own surveys and found, among other things, that doctor turnover is often much higher than the numbers claimed by HMOs. "You should never accept their statements at face value," he says. "Without auditing, HMO data is meaningless."

8. "We use second-rate parts." - "Top shelf" doesn't quite describe the hip or knee replacements you may get from an HMO. In fact, "generic" may be more like it. "HMOs will often use less-expensive versions of medical devices," observes surgeon Malawer, who consults with several medical-device companies. "In fact, there are entire product lines developed for the HMO market."
Although there's a constant stream of new devices coming into the marked, don't count on getting the latest rechnology, either. "There are often better medical devices on the market than are being used, but HMOs are engaged in a policy of silent rationing," argues Steve Speil, a spokesman for the Health industry Manufacturers Association. "They don't tell the patient about the alternatives because they would have to spend the extra money."

How can you tell if you're getting the real thing or a house brand? Ask how it's made. Most implants are made by either a forging or a casting process, says Dr. Charles Miller, professor of orthopedic surgery at the University of Virginia Health Sciences Center. "Forging is much, much stronger." For major work, such as hip replacements, "these less expensive cast implants are not appropriate," he adds.

9. "Send you to an expensive therapist? Are you Crazy?" - Treating mental health is one of the trickiest issues for any insurer, whether it's a fee-for-service plan or an HMO. How much therapy, after all is really enough?

Unfortunately, some HMO critics say, managed-care companies have an easy answer to that question: very little. Their response is often to prescribe medication instead of therapy, because it's so much less expensive, says Russ Newman, an executive director at the American Psychological Association. Medication is not an improper treatment," he adds. "It's just that [in some cases] therapy is being completely excluded."

Dr. Edward Gordon, president of the New York State Psychiatric Association, cites a recent case involving a severely dysfunctional family enrolled in the Physicians Health Services HMO. The father had drug and alcohol problems and was threatening his wife. Their child was suffering from learning disabilities and chronic depression. Gordon would have recommended family counseling at least once a week. But the HMO- whose mental-health care was administered by a separate company, CMG health allowed only four visits each for the mother and child during a three-month period. Meanwhile, the two were put on antidepressant drugs. "CMG has a reputation for being single-mindedly focused on reducing services, " says Gordon. Responds Alan Shusterman, chairman and CEO of CMG, "We are hard-nosed, but not about cost; [not are we] antipsychiatry. We're very aggressive about trying to get patient the most efficient and effective care possible."

10. "Unhappy? Go ahead, just try to sue us." - Since doctors have long been a magnet fro mal practice suits, you might think that HMOs-which often dictate treatment- would now be taking their share of litigation hits. But not so, for most HMOs have been cloaked with a protected status rivaling that of the spotted owl.

For many HMOs offered through large or midsize employers, state law is superseded by the Employee Retirement Income Security Act of 1974 (Erisa). Because Erisa was originally intended to regulate employee pension plans, there isn't much specific to health-plan regulation and, as a result, the legislation makes lawsuits against a health plan an uphill and unprofitable battle.
For starters, any suit against your Erisa-governed HMO is properly a matter of federal law. "Being federal law, it's more-ambiguous legal terrain and there are fewer [plaintiff's attorneys available," says Mark Heiplerm a California civil litigator who has successfully sued several California HMOs. Worse, under Erisa you have no chance at any punitive-damage award. "All the HMO has to do is pay for the disputed claim with no interest paid," says Carol O'Brien, a senior attorney with the America Medical Association. "There's only the possibility of attorneys fees and cost (of treatment) but no damages."

Three exceptions: If you're a participant in a government plan or a plan sponsored by a tax-exempt organization, or if you buy your health insurance n your own (not through an employer), you plan is not covered by Erisa. Under these circumstances you have the potential to be awarded both bad-faith and punitive damages, says Hiepler. Otherwise, you're out of luck.

Health Insurance can be very tricky. Arm yourself by reading the policy exclusions and limitations before you buy their plan. Most insurance companies will reluctantly give you a sample policy before you buy if you ask them. Always remember... they are in business to make money, anyway they can.

This article would seem funny, except for the fact that it is true.

I have written several other articles on related subjects for your information and caution. Shop wisely.

Athletes May Prolong Their Careers With Knee Replacement


Athletes are finding that the prolonged impacts of running, jumping and even being tackled are causing undo stress on their knees and joints. These effects are long lasting and could ultimately require a partial or total knee replacement. Knee replacement surgery is becoming an option for more and more athletes as they extend their careers rather than just retire due to the extent of their injuries. The road to recovery can long and arduous but with the consultations with their doctor and rigorous physical therapy they can regain nearly full mobility and it may be possible to again return to their sport.

Physical therapy can be the key to a faster and more efficient recovery. There are a variety of programs designed to help athletes get back to their vitality following knee replacement surgery. A physical therapist will generally visit the patient the day after the surgery and begin helping the patient to gently extend the joint. Intense pain can be an issue immediately following the surgery. Once the sutures have been removed, the patient can begin swimming and participating in aqua therapy in conjunction with other types of physical therapy. The use of flex machines and other therapy programs after surgery can help increase flexibility for knee mobility. These days, knee replacement surgery and the following physical therapy can give an athlete further options for extending their lucrative careers.

Although strenuous and impact heavy sports are generally discouraged, it is possible for an athlete to resume their normal activities within reason. The recovery process can take anywhere from a few months up to a year, and varies patient by patient. Low impact sports such as golf or swimming can be resumed for some athletes within the first 12 months of having a knee replacement surgery. Higher impact activities such as running, cycling and jumping can take longer for the athlete to recover from and re-acclimate. Recovery times vary from person to person. The more committed to their recovery that they are, and the more closely that they follow the instructions given to them by their surgeon and physical therapist, the more quickly they can be back on their feet.

Knee replacement surgery techniques and recovery times have made huge advances over the decades. Programs have been developed to increase the ability to prolong an athlete's career after having knee replacement surgery. Pain Free Knees, a program developed by Jerry Seaman, following his own knee replacement surgery has had fantastic results for many patients. Visit http://www.knee-replacement-video.com today to see what a difference this patented program can make in your recovery.

Unable to Lose Weight After Knee Surgery? Here Are Ways to Lose Even If You Are Immobile


I encounter a lot of clients who have bad knees or have recently undergone knee surgery who fear that they will now be unable to lose weight because they are so immobile. This challenge does not have to stand in the way of your weight loss, it simply means you will need to shift your efforts to what you can do. If you have been challenged by bad knees and want to lose the weight then I encourage you to read on.

Unable to Lose Weight After Knee Surgery

1. You will want to shift your carbohydrate intake. Carbohydrates are looked at by your body as energy foods and when your body needs energy it burns them up efficiently. When you are less mobile you need to be smart with your carb intake. Feed yourself carbohydrates (bread, cereal, pasta, potatoes, corn, rice) early in the day when your metabolism and energy needs (even when you are not physically active) and then keep them out of your diet later in the day.

2. Keep refined carbs out of your daily diet. If you are eating refined carbs such as baked goods, white bread and candy at anytime of the day you are making it harder for your body to lose weight. These foods break down quickly in your body and cause a spike in your insulin level. When your insulin is on the rise your body turns more of the foods you eat into fat and burns less fat.

3. Any activity is good activity. If you are having trouble with your knees you can still exercise your upper body. By exercising with weights you help your body preserve your muscle mass. This is key to keeping your metabolism running strong and helping you control your weight. Every pound of muscle you have on your body burns about 50 calories a day so by training with weights every other day you allow your body to burn more calories even when you are resting.

Do not give up hope and think that you are unable to lose weight after knee surgery, there are always things you can do to get the pounds off and of course this can only improve your mobility.

Frequently Asked Questions About Knee Arthritis


What are my chances of developing arthritis in my knees?

Your chances of developing arthritis overall are fairly high. Osteoarthritis affects approximately one in 6 adults at right around 50 million people. If you are a woman, your chances are slightly higher than men for developing arthritis. But overall the chances are approximately 15 to 20%.

What are the different types of arthritis?

The most common type of arthritis by far is osteoarthritis. This is a degenerative joint disease that comes on from wear and tear from normal activities. It is due to cartilage that normally covers the ends of our bones deteriorating. This causes pain and loss of range of motion as bone begins to rub against bone when the cartilage is gone.

Additional types of arthritis include rheumatoid arthritis which is an autoimmune disease, gout, ankylosing spondylitis, juvenile arthritis, lupus, and some people include scleroderma and fibromyalgia as types of arthritis.

Who is most commonly affected with arthritis?

As mentioned arthritis afflicts more women than it does men. There are so many types of arthritis identified, it affects people in all age groups including children to the tune of 300,000. Most commonly at risk are those termed "baby boomers". Over half of those afflicted with arthritis are under the age of 65.

What treatments are available for arthritis?

The treatments for arthritis will depend first of all what kind of problem the patient has. If it's an autoimmune disease such as rheumatoid arthritis then there are various medications such as methotrexate or low-dose steroids that may be effective. The same is true for lupus which is another autoimmune disorder with treatments by a rheumatologist often being extremely effective. When a person has gout there are medications to help counteract the situation and to help prevent it from coming back. The medications prescribed for gout will vary depending on which type the patient has.

The most common type of arthritis, osteoarthritis, has multiple levels of treatments available. The first would include activity avoidance, which means that if a certain activity flares up arthritis pain it should be avoided. Secondly, there are medications that can help a lot such as anti-inflammatory medications and Tylenol. These should always be taken according to the manufacturers recommendations. Injections of steroid medication can help significantly in osteoarthritis along with the other types as well including rheumatoid arthritis.

There is an additional type of injection frost urethritis which consists of hyaluronic acid injections. These help replace the lubricating joint fluid and can promote the body to make more. There are also some nutritional supplements called glucosamine and chondroitin sulfate which can help protect cartilage and also promote the body to make a little bit more.

At what point do I need surgery for my arthritis condition?

Arthritis is not a fatal condition. Therefore, having surgery for arthritis is a quality of life decision and should be considered a last resort. Only the patient him or herself can know just how bothersome the arthritis is. Therefore, after substantial nonoperative treatment has been tried, it can only be up to the patient to decide just how much pain they are in, how much pain they can tolerate, and whether surgery is right at that point in time.

Exercise at Home - No Equipment, No Problem!


You have a million things to do and spending 2 hours at the gym just isn't one of them. Sometimes there just isn't enough hours in a day. If you exercise at home you cut out all that driving time and it seems more manageable. Having said that, don't think you're off the the hook. We can still get your heart rate up, boost your metabolism, and get results all in the comfort of you own home.

The secret to getting the most out of your workout at home, and in the gym, is performing your workout in the form of a circuit. By moving from one strength training exercise to the next you will get you heart rate up and knock out strength training and cardio in a matter of 30 minutes and leave your metabolism elevated for hours...all without equipment!

Here's the plan.You are going to perform five exercises with no rest in between. If you are just getting started allow yourself to rest 15-20 seconds in between each move and work your way up to not resting at all. At the completion of all five exercise you will rest for 1-2 minutes. Then, move on to the next five exercises and perform them in the same fashion. Repeat the two groups of exercises 1-2 more times.

Group 1

1. Push-ups: 15 reps


  • Lie face down with legs extended out behind you and feet together


  • Place your hands slightly wider than shoulders width apart, palms down, elbows at a 90 degree angle


  • Wide Push-up Option:
  • Start with hands about 3 inches wider that the regular push-up

  • Straighten arms, keeping abs tight and lift up on your toes (or knees for a modified version)so your body is flat like a table...get that butt out of the air!


  • Keeping your body straight, lower body to the ground by bending your elbows until your upper arms are parallel with the floor


  • Return to the start position by pushing yourself back up


  • Important:
  • Keep your spine in line by keeping your eyes focused on the floor and your abs tight...don't let your body sag on the way up. Also, exhale on the way up and inhale on the way down.Important: Get your butt out of the air! And don't let your body sag! Keep your back straight, your spine in line and just hold the position.

2. Squats: 25 reps


  • Stand with feet about shoulder width apart, weight on heels, abs pulled in and good posture


  • Using weight...hold dumbbell with both hands directly in front of your body


  • Lower yourself down and back by bending your knees. Stick your butt out and keep a straight back


  • Lower yourself down until your upper thigh is parallel to the ground (almost as if you are about to sit on a chair)


  • Dumbbell hangs straight down in between legs


  • Exhale Return to the start position by straightening your legs


  • At the top, squeeze your butt cheeks together like you are picking up a $100 bill


  • Turn them into jump squats for more of a challenge


  • Important:
  • Never let your knees extend past your toes. Keep a straight back. Don't lean forward (shoulders back) and don't let heals lose contact with the ground.

3. Abdominal Planks: 45-60 seconds


  • Start in push-up position: back straight, legs directly behind you, up on your toes,hands directly under shoulders and arms straight


  • you can start out on your knees and work up to being on your toes


  • You are balancing your weight on the palms of your hands and the balls of your feet


  • Hold this position for as long as you can...start with a goal of 30sec and work up to a minute plus


  • Place your hands further out in front for more of a challenge

4. Lunges: 15 on each leg


  • Stand with good posture


  • Feet together


  • Step straight out with one foot about 2 feet


  • Lower upper body toward the ground keeping front knee behind toe and shin perpendicular to ground


  • Push back up with front leg and return to start position with a controlled movement


  • Switch and repeat


  • Important:
  • Knee should not touch ground. When knee extends out passed the toes this causes unnecessary stress on knee. Also, keep a good posture...try not to lean forward

5. Jumping Jacks: 60 seconds

  • you know the drill

Group 2

1. Pelvic Thrusts: 15 on each leg


  • Lie on your back with your heels on a bench or chair...your legs should make a 90 degree angle


  • With your arms relaxed at your side, raise the left leg up so it is pointed toward the sky...keep foot flexed (don't point your toe)


  • Pressing the right heel into the bench or chair, drive your left heel straight up toward the sky by lifting your hips


  • Pause and slowly lower your body down until it almost touches the floor...repeat for instructed number of reps and switch legs


  • Important:
  • Remember to breathe. Exhale as you drive your leg toward the sky and inhale on the way down.

2. Tricep Dips:15 reps


  • Position yourself with your butt just off the edge of bench or chair with hands next to your hips, fingers curled under chair, knuckles facing forward


  • Feet are out in front of you at a 90 degree angle (more advanced - legs out straight, motivated- heels on another chair or stability ball)


  • Lower your body toward the ground by bending at the elbows


  • Go as far as you can or until your arms are at a 90 degree angle


  • Return to the start position by straightening your arms


  • Inhale on the way down, and exhale on the way up


  • Important:
  • Don't let your elbows flare out. Don't let your chest collapse as you lower down. Don't perform this exercise if you have a shoulder injury or wrist pain

3. Chair Sits 20 seconds, rest for 5 seconds, back down for 20 more seconds


  • Stand with your feet together, good posture, weight on your heels


  • Bend your knees and lower your butt to the ground until your upper leg is almost parallel to the ground...don't let your knees get over your toes


  • Bend forward slightly at the waist


  • Keeping your arms straight, raise your arms up to the sky until they are right by your ears


  • Jump your feet up toward your hands and land so you are in the squat position


  • Now jump straight up in the air, getting your feet off the ground and reaching for the sky


  • Land in the squat position, place your hands back on the floor and jump your feet back to the push-up position


  • Important:
  • Keep your knees behind your toes and weight on your heels. Don't let those arms drop...we don't want your shoulders to miss out on the fun!

4. Superman: 15 reps and hold for 15 seconds after last rep


  • Lie face down with legs straight out behind you and arms straight out in front of you...like Superman


  • Lift you arms, chest and legs off the floor...squeeze your butt cheeks and hold for a beat!


  • Return to the start position, but don't let your feet and hands touch the ground. They should hover a couple of inches above the ground.


  • Important:
  • Nice, slow controlled movement

5. Mt. Climbers: 60 seconds


  • Start in the plank/push-up position with your body in a straight line, hands directly under your shoulders


  • Jump your left foot forward driving your knee up toward your chest (left foot stays off the ground)


  • Your right foot stays out behind you in the start position


  • Very quickly, return your left foot to the start position and simultaneously, repeat the same move with the right foot


  • Repeat at a rapid pace for the instructed amount of time

There you have it...what are you waiting for. Remember to keep that heart rate up and really challenge yourself for maximum calorie burn. Perform 2-3 days a week (non-consecutive days) other day and check out real-moms-real-fit for more pre-designed workouts.