Saturday, February 15, 2014

Colitis - Can Probiotics Help Your Symptoms?


There are many ways to improve Colitis symptoms one of the most effective that I have found is taking Probiotics regularly Did you know there is more bacteria in your intestinal tract than there are cells in your body?

Benefits of Probiotics -
o They reduce diarrhea
o They are anti-inflammatory
o They Manufacture B complex vitamins
o They help regulate bowel movements
o They create lactic acid that balances intestinal pH levels

There are many other benefits from Probiotic's but these are the main ones we are concerned with in Colitis. Probiotics really work by reducing your diarrhea and lowering inflammation levels in the bowel. When I first took the right type of Probiotics in the right quantity I was amazed at the results, they really improved my stool consistency back to normal in a matter of days.

There are several ways of getting Probiotics into your Diet -

Supplements - There are many many Probiotic supplements for sale out there and it can be confusing knowing which one to take. What you need if you have Colitis is a high powered probiotic with multiple strains of bacteria in it. The best types need to be refrigerated, to keep them fresh and ready for action when they arrive in your intestines. I take one sachet of probiotics containing 450billion live bacteria once a day before bed in a small amount of live goats yogurt. This I find very useful in keeping my bowels regular and my stools well formed. If I feel things are a little bit loose one day then I just take an extra sachet during the day and that gets things back on track.

Kefir - Kefir is a cultured, enzyme-rich food filled with friendly micro-organisms that help balance your "inner ecosystem." More nutritious and therapeutic than yogurt, it supplies complete protein, essential minerals, and valuable B vitamins. It really is amazing stuff and the good news is that you can make it at home yourself with very little effort or cost! Kefir provides a virtual Swat team of probiotics which get straight to work cleaning up your intestines. You make Kefir by putting Kefir Grains which look a bit like small bits of cauliflower - and are a living microorganism - into a jar of milk. The Kefir then eats up all the lactose in the milk and as a byproduct produces lots of natural living probiotics which when you drink them help your intestines to function better. I drink a glass of my own home made kefir every morning as part of my breakfast because as well as being an excellent probiotic it is also an excellent nutritious food.

Arthritis Treatment: Is Osteoarthritis Just Wear and Tear? No, And Here's Why!


Osteoarthritis (OA) is the most common form of arthritis affecting, according to the latest statistics from the Arthritis Foundation, about 28 million Americans.

OA has been primarily felt to be a disease of hyaline articular cartilage with secondary involvement of the synovium (lining of the joint), and subchondral bone (the bone underneath the cartilage.)

The antiquated notion of OA being a "wear and tear" disease has been supplanted by the new theory that OA is a combination of a mechanical wear process as well as an inflammatory process.

This has been supported by the fact that cartilage has no blood vessels nor does it have any nerves. Yet OA causes pain. This pain is felt to be due to inflammation involving the synovium. Cellular changes in flamed synovium in OA are not that dissimilar to the findings seen in rheumatoid arthritis.

In fact, it is the synovium that appears to drive much of the inflammation seen in OA. The synovium is lined by macrophages, cells that are potent producers of inflammatory cytokines- proteins that drive inflammation. The synovium is also rich in blood vessels and nerves.

Recent evidence though also supports the notion that chondrocytes (cartilage cells) also have a role in inflammation, this despite being relatively sparse, and located far away from blood vessels and nerves.

In fact, inflammation at the chondrocyte level might have a permissive effect on the inflammation involving the synovium... a sort of "ping-pong effect."

The question then becomes, what causes the chondrocyte inflammatory response to start in the first place. There have been reports that perhaps debris from dead cells or other protein based material originating from degraded cartilage might serve as antigens (protein triggers)to induce an inflammatory response by chondrocytes. Technically, this would be an autoimmune response by cartilage. This idea of OA being an autoimmune disease was described in an excellent editorial. Read this: (Konttinen Y, Sillat T, Barreto G, Ainola M, Nordstrom DC. Arthritis Rheum. 2012. 64: 613-616).

So why is this important to treatment? It may be that OA should be viewed in the same light as other autoimmune forms of arthritis. This might drive the investigation for OA specific therapies.

In addition, it is also recognized that cartilage has a limited ability to heal itself. It may be the newer techniques of providing mesenchymal stem cells to osteoarthritis cartilage as a method for helping cartilage to recover from injury might not be such a bad idea after all. It may be the underlying inflammation involving cartilage could actually help with the repair process.

Finally, a recent study showed that perhaps neurotransmitters can modulate the metabolic activity of chondrocytes. These substances might prove to be helpful in cartilage regeneration. An excellent discussion of this intriguing idea was recently published. For more details, read this: (Opolka A, Straub RH, Pasoldt A, Grifka J, Grassel S. Arthritis Rheum. 2012; 64: 729-739)

Arthritis Inflammation Symptoms, Treatments


When you suffer from arthritis, you experience severe inflammation in your one or more joints. Injuries, fractures, dislocations and the resurfacing of old injuries are the factors that can lead to joint inflammation.

While injuries and infection may trigger inflammation, the most common cause is arthritis. There are hundred kinds of arthritis but not all types cause inflammation. The most common arthritis types associated with inflammation include:

Rheumatoid Arthritis
It is an autoimmune disease in which the body's immune system attacks the joints causing painful inflammation in joints. The most common symptoms are joint pain, swelling, stiffness, tiredness, depression, and anaemia. Some patients also develop flu-like symptoms, such as feeling ill, feeling hot and sweating.

Some less common symptoms of rheumatoid arthritis include inflammation in the eyes, rheumatoid nodules and weight loss. In rare cases inflammation may occur in other body parts, namely lungs and blood vessels and the membrane around your heart.

The initial treatment options available for rheumatoid arthritis are physical therapies and anti-rheumatic drugs- painkillers (analgesics), non-steroidal anti-inflammatory drugs (NSAIDs), disease-modifying anti-rheumatic drugs (DMARDs) and steroids.

In cases where body joints give severe pain, stiffness and immobility replacement surgeries like knee replacement hip replacement may be needed.

Psoriatic Arthritis
This arthritic condition causes painful inflammation in and around body joints and tendons. Symptoms of this condition include inflammation in your spine (spondylitis) causing stiffness in back or neck, swelling in and around your fingers or toes (dactylitis), buttock pain, inflammation where tendons attach to bone (enthesitis) causing pain and swelling in your heels, knee, hip bones and chest.

NSAIDs and DMARDs are most often used to treat psoriatic arthritis. In very rare occasions, surgery is used to repair damaged tendon. The joint that has been long damaged by inflammation is best treated with joint replacement surgery.

Gouty Arthritis
Gout is considered as the most painful form of inflammatory arthritis. The symptoms of gout are caused by abnormally high level of uric acid that builds up and forms crystals in the joints, which can lead to recurring attacks of joint inflammation. Gout most commonly affects the small joint at the base of the big toe but it affects other joints as well, including the ankles, knees, fingers, wrists, and elbows.

Symptoms of gout usually include intensely painful and swollen joints, redness and warmth on the affected joint and red or purple skin around the joint.

Treating the gout usually involves either anti-inflammatory drugs or steroids that can help reduce the pain and inflammation of gout attacks. Some certain medications decrease the level of uric acid in the bloodstream. Many gout patients turn to natural methods to reduce the risk of future gout attacks. In order to prevent gout flares you should modify your diets- avoid overindulgence in meat, seafood and alcohol; and drink more water- consume beverages that contain more water. Losing weight, following a moderate exercise regimen and taking supplements can be of great help.

Systemic Lupus Erythematosus (SLE)
Also referred to as Lupus, it is an autoimmune disease in which the body's natural defense system attacks healthy body cells and tissues. This inappropriate response of body's immune system causes inflammation which in turn leads to pain, swelling and tissue damage throughout the body.

Some lupus sufferers develop only mild symptoms, including tiredness, joint pain, swelling (arthritis) and fever. In some cases skin rash, hair loss and mouth sores can also occur. The times when symptoms get worse the patients may experience problems with the heart, kidneys, blood cells, lungs, or nervous system.

Lupus can be best treated by taking nonsteroidal anti-inflammatory drugs and applying medicated cream for rashes. Taking proper rest, avoiding the sun and regular exercise can help you cope with the condition.

Knee Replacement Failure, Avoiding Muscle Imbalance


Having a knee replaced can be a wonderful thing if you have been in extreme pain for some time. The chronic pain that is associated with an arthritic knee not only can be crippling but, it also begins to atrophy and weaken the surrounding muscles that support the knee. There are many aspects of the surgery that have to be completed well to avoid knee replacement failure but, one of the things that you as a patient have complete control over to assure your knee does not fail is to build as much strength around it as possible.

Your physical therapy will consist of a multitude of exercises to help not only strengthen the knee but, get as much range of motion as possible. One of the biggest mistakes I see patients possibly commit after rehabilitation is to think that all that has been done is all that can be done. One of the best things that you can do after your physical therapy is to work on a strengthening and conditioning program for the knee.
Your knee has to have strong muscles that surround it to avoid muscle imbalance. If you do not continue to strengthen the knee, then the joint takes on more of our bodyweight then it should and prematurely wears out the prosthesis.

It is important that you continue to strengthen the quadriceps, hamstrings, and the calf muscles so that they support your weight when you walk rather then the joint. If you have suffered with knee pain for a long time your walking mechanics have been compromised and part of the rehabilitation process is to get you walking right again. Strengthening the muscles around the knee can be done in several ways. The exercises generally given by your surgeon will involve water based activities or pool exercises. Though these are great exercises for a large portion of the population, I would recommend if you are a younger adult, a more aggressive strengthening program for the affected knee and leg as a whole.

For strengthening the quadriceps I would recommend the leg press or the squat using light weight.
I have found over the years these have been the best exercises for strength building around the knee. I have incorporated them into my leg routine for over 10 years now without any difficulty. The lighter weight here will build both strength and endurance in the thigh muscle.

For the hamstrings, seated or lying hamstring curls are excellent. Again, light resistance is all you need. You will find much later that your leg can handle more weight but there is no need to, keeping the hamstrings strong is the issue here and they will respond to lighter weight.

The calf muscles are generally neglected by everyone. I recommend getting inside a standing calf machine and use light enough weight that you get a full range of motion with the exercise. This will develop more strength underneath the knee and,also will help tremendously with your balance as it strengthens the ankle and foot.

The number of repetitions you can do is between 12-15 on each exercise. These exercises of course are not for everyone. Your surgeon will tell you "do not do that" unless they are proponents of the weight game they will be rather passive in their exercise recommendations. We all can agree on however that you stay away from high impact activities on either the hip or knee replacement like running for instance.

With this protocol I have had wonderful results with my replacement and the knee has held up just fine.In fact, I think it has done as well as it has due to the exercise and the further development of the muscles and ligaments around it.

If you belong to a local gym or health club in your area there is equipment that you can use that will bring you along slowly. The smith machine for instance is a fantastic machine to squat in. Give them a try along with using the stationary bike and see the results you obtain in building a stronger knee that is more reliable for the future.

My Twins and Me - Life After Knee Surgery


2005 had arrived not soon enough for the twin sisters, they had gone through and successfully had rehab done on knee reconstruction surgery in 2004. They continued training harder and harder working on their squat, calves and hamstring area of their injured leg to help build up that support their knee would require with the tough sporting season ahead. This preparation was vital to no more issues with there knee and to mentally get them in that go forward mood and preparing for the up coming challenges of their favourite sport netball in 2005. They had set goals together on where they want to be in the 2005 season.

What goals should be set?

Goal -1 - Stay injury free.

Using the methods learned through their rehabilitation time before and after their knee surgery. The other factor was that they gave more than a 100% in rehab to get back to this stage of their recovery process. Also being mentally and physically fit was a huge bonus as well for their come back trail in the their sport of choice netball. Along with this goal of staying injury free they had to put their knee to the test of physical activity, then and only then can they be confident enough to really push forward.

Goal - 2 - Keep improving training systems.

This is to benefit the recovery progress through their netball season, remembering that your training will help you to excel in your preferred sport but also in your physical being. With this there has to be a balance of how much and how far you push your self with these new systems, remembering that every now and then you will need a break to rest and re-energize. The program you will require will need to be written up by a person who specializes in the particular sport of your choice and with also the ability to input other sporting techniques to improve you on your quest.

Goal - 3 - Make representative teams.

With the training programs you put into place to support your self they should improve your chances of making these representative goals. Obviously over coming your injury so that your are 100% fit will also increase your shot at that level. The other factor is that most representative sports are near the end of a season, so your actions through the season at the top level of play will also contribute to your success. Through the season the top coaches of these teams will do the rounds to select prospects for trials or will have someone attend these fixtures to do it for them. So being prepared and injury free is a big bonus to making the top-level teams.

How do you prevent the injury re-occurring?

By completing your goals you have set up and following through with them religiously and having faith in your body and your abilities to come out on top. Listen to the experts; your physio and surgeon with any advice they have to give you regarding protection of your injury as your build up your physical strength again. Learn about your injury on how it can occur and be prevented from happening again to the same leg or the other. There will times when this injury cannot be unavoidable but preparation before hand will increase your chances of this not happening.

So your goals and aspirations will only happen if you put in the hard work you need to do to succeed, because there will be others who are not coming back from a serious injury that will be training just as hard as you to make it to the next level in their sporting careers. Use the resources available to you and do not be afraid to ask for help.

Best Herb For Joint Pain Relief


Herbs vs. Drugs for Pain Relief

Joint pain relief is one of the biggest challenges for people who have arthritis or aching joints. Side effects of prescription drugs have proven to be so dangerous that some drugs have even been withdrawn from the market. Natural pain relievers, however, offer arthritis pain relief that is comparable to that of drugs, with the advantage of having little or no negative side effects.

Research in Complementary and Alternative Medicine

The national medical database in complementary and alternative medicine at PubMed (U.S. National Institutes of Health) lists more than 6,000 research articles on arthritis. Hundreds of herbs worldwide have been discovered to relieve the pain of inflammation. Very few of these, however, have yet to become available to the public. Some of the more widely known anti-inflammatory herbs that are generally available as supplements include turmeric (Curcuma longa) and ginger (Zingiber officinale), both of which are in the ginger family, Indian frankincense (Boswellia serrata), Devil's claw (Harpagophytum procumbens), and white willow (Salix alba). The best one, however, continues to be under the radar - i.e., the creosote bush (Larrea tridentata). Research over the past few decades shows that the antioxidant-rich leaf resin of this plant contains unique ingredients that inhibit enzymes in the inflammatory pathway that causes pain.

Mother Nature's Pain Reliever

I have to admit my bias in favor of the creosote bush. I have been doing research on the natural products chemistry of this species for more than 35 years, first as a graduate student and then as a professor. My interest began when I had a conversation with an old rancher in Arizona who told me that the creosote bush was the best herb he ever found for treating his horses for joint pain. All he had to do was make a poultice from leaves and young stems, strap it directly onto the inflamed joint, and watch the inflammation go down. Since then I have come to admire the creosote bush's rich folk medical history among native people in the deserts of the U.S. southwest and adjacent Mexico. Folk medical uses of the creosote bush have paved the way for modern research. Scientific studies confirm what non-scientists have known for centuries. Unique ingredients of the creosote bush bolster this plant's anti-inflammatory power and ability to relieve pain.

How to Use the Creosote Bush for Pain Relief

The simplest method is to apply an old-fashioned poultice. Warm and moisten a handful of leaves and young stems, then put them directly onto the painful joint. Hold the whole thing in place with a bandage. Change every 12 hours. This technique, of course, requires that you have a source of fresh creosote bush leaves. If you live in the southwestern U.S., the plant will be easy to find, because it is the most common shrub in the three main deserts of west Texas/New Mexico (Chihuahuan Desert), Arizona (Sonoran Desert), and California (Mojave Desert). A more practical method for people who do not live in the native habitat of the creosote bush, and even for most people who do, is to use a preparation that is already designed for topical use. This kind of preparation may be a little difficult to find, since most health stores do not carry it. Nevertheless, a quick internet search should yield some good possibilities.

Who is Using Creosote Bush Now?

At the moment, topical preparations have become especially popular among golfers who suffer hand or elbow pain. In my own experience, the slight pain that I used to have in my left hand was a distraction for me when I played golf. Application of a creosote bush spray preparation directly onto the painful joint eliminated that distraction (and took away a great excuse for a bad shot!). A handful of professional athletes in baseball, football, and basketball have also benefitted from creosote bush treatments of sore ankles, knees, elbows, and shoulders. This herb will certainly become more popular for treating joint pain as successful stories such as these become better known.

Friday, February 14, 2014

Patellofemoral Knee Pain - An Overview of PFPS - Braces That Help


Is your kneecap unstable?

Do you suffer from knee discomfort at the same time?

When you experience either one of these issues, it can be a very unsettling experience.

If you have ever had this happen to you, you might be seeing early signs of patellofemoral pain syndrome (PFPS).

Patellofemoral Pain Syndrome (PFPS) - An Overview

The term "PFPS" can also be known as "anterior knee pain" and/or "runner's knee" in different medical information that you will find.

There are many muscle groups and ligaments that help control the movement of the patella. The patella and the femur come together to form a joint known as the patellofemoral joint. This joint is made up of muscles, soft tissue attachments and the trochlear groove where the patella moves along. As long as it stays "on track" you probably will not experience any patella deviation.

PFPS is a knee condition in which people usually indicate that they have pain "around" or "under" the kneecap. Sometimes this condition is also referred to as chondromalcia patella, but various medical authors have disagreed on the validity of this statement...

Typically, your kneecap is designed to move smoothly along a groove on the femur or thighbone, called the trochlear groove. PFPS, is believed to be related to poor kneecap (patella) "tracking".

The patella can be pulled off the track of the trochlear groove and can deviate off of your true knee center position. This can occur when the front thigh muscles are weak and imbalanced, causing pressure and strain on the cartilage on the undersurface of the kneecap. - Patellar dislocations are more likely to occur when your knee is moving; this is more commonly seen in runners and athletes.

Causes of Poor Knee Tracking

There are four conditions that can predispose poor tracking of the patella along the femur, and it is important to see your physician if you believe you have one of these problems.

- Weak Quadriceps- The front thigh muscle or the quadriceps become weak and can cause an imbalance as the patella slides over the groove along the femur. A supervised strengthening exercise can help correct this poor knee tracking issue.

- Imbalanced Quadriceps - The four divisions of the quadriceps can become imbalanced. The kneecap is pulled off center as a result of the imbalanced pull by the outer quad and the inner quad. This condition deteriorates over time to become full blown PFPS.

Rehabilitative exercise can also help correct this imbalance of the quadriceps and correct the painful knee experience. If this is done at the early stages of the muscle problem you may be having, the condition may not deteriorate into PFPS.

- Weak Hamstrings - This imbalance occurs when the muscles in the front of the thigh (quadriceps) becomes stronger than the hamstrings. This condition can put a strain on the quads causing increased pressure on the femur and the kneecap.

Treatment of PFPS

There are two types of medical interventions used to help treat Patellofemoral pain syndrome- invasive and non invasive treatments.

Under a more severe condition, the surgical option might be recommended by your orthopedist (consult your physician for medical advice). The surgeon can either perform an arthroscopic lateral release, which will help correct the tracking of the patella, or do ligament tightening.

A support, sometimes referred to as a patellar tracking knee sleeve (or patella tracking knee brace) can be used to help limit any deviation of your kneecap. This is a very helpful support while you participate in rehab, especially when your muscles may be weakened. Further, the use of a knee brace can relieve your knee of significant pressure and help ease the pain considerably. These supports should not be overlooked, and can really become your new best friend if you have knee problems such as PFPS.

The Human Knee Joint - Part 2


As the knee approaches the position where it is going to lock the femur rotates inwards, a movement which is only small but vital to the normal function of the knee, indicating its great complexity beyond a simple hinge. The minor movements which occur internally in the joint are restricted in the knee and it cannot manage to lose any of these small motions without functional loss as a consequence. Accessory movements are the name given to these limited gliding and sliding movements which normally occur during activity but which can't be done on their own.

The knee is subject to conflicting demands for both mobility and stability, needing to perform as a strong and predictable support and also to function to provide mobility very quickly. In the example of gait the knee has at one point to stabilise the body under its whole weight and next release the stability and move forward as a mobile segment. Walking then consists of a cycle of the knees locking to bear weight and then unlocking with predictable regularity, allowing a person to walk rapidly and make considerable progress without falling. As a knee gives early problems this may involve the loss of accessory movements.

The knee is very powerful but also capable of very fine movements in response to changes such as uneven ground. It has the power to allow us to squat down and stand up again without missing a beat. Side to side accessory movement in the knee is limited to a small range but this may help with adapting to an uneven surface, with a gapping of the inside of the knee joint the larger of the two movements due to the natural outward angulation of the lower limb and the weaker ligamentous support.

The first article about the knee covered the idea that the knee moves backwards and forwards and tends to stick in that plane, so if an abnormal stress such as to the side is added this changes the balance in the joint. The kneecap and the main knee compartments can experience wear changes if the knee suffers from bow-leg or knock knee. The knee is divided into two compartments, the medial and the lateral side, both with their own meniscus, ligament, femoral and tibial condyles. The stresses which are transmitted across the compartments vary with changes in the sideways angle of the knee.

The development of an amount of bow leg at the knee changes the quadriceps pull so the kneecap is pulled to the inside, pushing it more forcefully against the inner edge of the groove it sits in, which can result in a painful condition. Along with this there are increased loads on the lateral compartment and this can hasten degenerative changes on that side. Normal knee joints naturally have some knock knee but if this amount is increased then the outside of the kneecap is likely to suffer from impingement pain.

Patellar problems can also occur if the knee does not typically extend fully, as the knee remains slightly flexed and the quadriceps has to maintain knee stability, pushing the patella strongly against the femoral groove. These increased forces can be a cause of patello-femoral pain which is a very common complaint. If the knee has some abnormal lateral alignment then a small wedge under one side of the heel can realign the foot and shin bone from below and thereby make a very small but important change to the stresses through the knee.

The patella can also give problems in response to abnormal changes in other joints. As we get older our foot arches can become less strong and so less pronounced, sometimes leading towards a degree of flat foot. As the feet rotate inwards on weight bearing the whole foot and shin move inwards to some extent, introducing an amount of knock knee effect at the knee. This can cause the kneecap to glide more outwards along the groove than normal and lead to patello-femoral pain. An effective treatment can be to wear orthotics in the shoes, which can combine restoration of the foot arches with the necessary level of medial wedging of the heel.

Understanding Chronic Joint Pain - The Causes and the Effects


Thousands of people suffer from chronic joint pain (pain that lasts for a period of six months or longer). By understanding what causes it, a person suffering from chronic joint pain can better understand its effects and how to treat them.

There are many reasons why a person may develop chronic joint pain. It is not unusual for a traumatic event to be the root cause of continuous pain. Infection and inflammation are also known to be responsible for some chronic joint problems. Another fact about joint pain is that it is the most common type of pain, according to doctors and the schedule they see every day when they come in to work. Apparently, nothing gets a patient in the door quite like pain in those hinges we call joints.

The number-one grievance of patients by far is chronic knee pain. The knees are compromised of so many different parts that there are more chances of having a problem with this major joint. Runners, skiers and tennis players all know the drill when it comes to painful knees, but even non athletes are afflicted with knee pain because they use their knees every day to accomplish day-to-day tasks.

Chronic pain comes with its own set of problems. Joint pain, chronic or not, can rob people of activities that they enjoy. Over time and with increasing amounts of pain, people often experience complete changes in their lifestyle. Unfortunately, when relief is not attained after trying several different methods or products, it is not unusual to begin to feel hopeless and helpless. This can lead to emotional repercussions that move in along with chronic joint pain. It is not unusual for people to be afflicted with symptoms of depression and anxiety--an issue that is often overlooked when people are seeking treatment for pain relief. Pain that is not relieved can also affect the immune system as a whole. Overall health can become compromised just because of one painful joint and the stress of chronic pain.

For many people, finally finding a solution is a giant step in the right direction. Treatment after treatment with no lessening of the pain can be more than a little discouraging. Doctors and researchers are optimistic that joint pain relief is becoming attainable for even those with chronic problems.

One recent form of relief, Cetylated Fatty Acids (CFAs), is making a difference in the lives of those with chronic joint pain. Studies and personal stories are both emerging regarding this option. These acids have been proven to provide increased joint lubrication, which allows people to attain greater mobility. A boost in cushioning also helps to reduce inflammation and pain. CFAs are worth more than their weight in gold to a large section of pain sufferers out there.

Where and why knees and other joints have so many pain issues is an important topic and is being addressed by the medical community. Researchers continue to work hard to find solutions while restoring people to good health and happiness.

Achieving Blunt Power and Force For Striking


In the world of combat and martial arts, there are a variety of striking forms in which people have incorporated speed, power and torque to deal damage but what most martial artists who practice secular martial arts without training in others can not tell you is that there are three types of damages that a person can perform. In boxing we see jabs, straight punches and hooks as the main primary strikes; relying on pure form and precise rotation it sets the fist into the target zones horizontally, without any twists or such at the wrist- This is the first type of damage: Brute force.

In Karate, a punch is performed by twisting and rotation mixed to deliver a punch based on torque that is to give sharp, precise damage unlike boxing; which is based on pure brute force to knock the opponent out.- This is the second type of damage: Sharp Damage. The quick punches in Wing Tsun/Chun are based entirely on a whip-like motion that delivers a slap-types strike mixed with a balled fist to deliver a very breaching strike that knocks opponents towards the back a few inches, its through this concept they have created strikes to hit farther than intended range, this insures they give out a little more power while striking, even at close range - This is the third type of damage: Whip/Slapping Damage.

However, among all these three, none had relied at all on pure physics and bio-mechanics. All were created to apply pure- Head on collision with any part of the body. It however, has not even tried embracing the potential gravity can play in the damage.

Blunt force damage and heavy-handed strikes are usually based on weight but what people do not realize is gravity is the reason these damages even give a knock-back effect when executed. In Russian Systema, in all forms i.e Ryabko and Kadochinkova mainly, they utilize a fluid wavelike motion of movement and approach when striking and countering which transfers energy throughout the body in the form of momentum, this is the physical aspect that dominates the path of the punch however, it is the simple bending of will to the natural motion of the human flexibility that allows the punch to pack that snap and punch at the end that is accompanied with pure weight and projected force in the form of the ending chain for the energy transference.

How this is explained without such complications is simple. Try this simple exercise and see the difference in power and force:

With a training partner, get anything that is to absorb force such as a small punching bag, a kicking mitt, etc. Let your partner hold it up at chest level with both hands and you stand directly 2 feet away from it. Your partner should stand with legs apart at shoulder width with a slight spring in their knees; it can be spread one forward, one back or just beside each other - the spring in the back of the knees is important.

Execute any punch you know, be it a Karate punch, a boxing straight or even a hay-maker, just make sure you hit the mitt and not your partner.

After the execution, ask you partner if it was strong and gauge whether he/she was moved at all by the strike or punch, no matter how much the force.

Now standing exactly 2 feet away from the bag again, create a wave motion from legs upwards till your arms, when it reaches your shoulders roll them up and forward in one continuous motion then allow the hand to gather speed by slightly tightening the muscles at the forearm and near the elbow, let this roll carry your arm up until the elbow is already chest level then let the motion of the roll forward take effect, force your back to shoot the shoulder forward in the roll and allow your arm which should be slightly limp until the last moment it touches the bag, stay in fluid motion, the minute your knuckles crunch due to the applied pressure of both the bag and your arm forcing it horizontally unto the surface, clench your fist and project some muscle power and fully straighten out your arm while at the ending of the forward roll.

After execution, Measure how far you have moved your partner or how far he/she has bent their back to absorb your punch.

Done correctly with effective speed and precise fluidity and shooting of the arm, the shoulder and timing, the punch could easy be heard louder than a slap and the force would be projected beyond the mitt your partner was holding. The force that "pushes" your partner back will come from one simple shoulder roll and if you knew the other techniques involved, you could have put a man on the floor with the force of a sledgehammer hitting a person in chest.

This is the primal and natural instinct of flowing with energy and motion that it gives extreme momentum to perform this powerful strike. To understand the concept, its momentum + speed+ gravity+muscle force = A successful Systema punch.

A Systema punch is not slow, it can be done in similar speeds of a boxing punch or could be as fast as a Wing Tsun whip. It is purely based on circular motion, which makes this style of striking, an endless stream of forceful strikes, slaps, mauls, etc.- Always mixed with the pulling and heavy force of gravity.

Magnetic Knee Brace - Alternative Pain Healing


A magnetic knee brace takes the concept of the magnetic wrist band further. A magnetic knee brace can be seen as another option in a long line of alternative therapy. It provides for a brace that is more comfortable to wear and more natural in terms of treatment. Apart from the compression that your injury needs, this brace will support knees and stimulate a sense of relaxation. Blood circulation is also helped by these braces.

Magnets have long been used for disparate healing purposes, in homeopathic medicine, in particular. A knee brace is yet another substitute. A magnetic knee brace is advised for certain damages to the knees. Some of these are:
1. due to sports
2. in severe arthritis
3. post knee surgery.

Other cases may be where a cartilage is torn or if you are suffering from a sprain.

A magnetic knee brace works by utilizing natural magnetic fields. The braces acquire heat from the user's body and preserves it. This heat relaxes the body. Also, they help in calming capillary walls of the legs, leading to better blood circulation. The knee gets more oxygen in this way, healing the injury quicker.

Increased oxygen supply helps reduce any swelling that might have formed due to the injury. There will be lesser stiffness in the knees which will ultimately decrease the pain from the injury. Muscles that are constricted will unravel and mend sooner. This is because the knee brace are elastic, they keep the knee stable. The heat also aids this.

As magnetic braces are elastic wraps in nature, they are easy to wear and even carry around. They can be easily worn under clothing. Since they are working constantly, it is best to wear them at all times for speedy recovery.

However, there are some things to keep in mind while buying and using a magnetic knee brace. Pregnant women should never use these braces. They should be used over a wound that is still open. Never keep your brace around electronic items, it will interfere with the natural magnetic fields. The brace might also affect skin and therefore, if you are prone to skin irritation or rashes, it is best to keep clear of them.

While choosing a brace, check for its fit. It should not slide too easily and must be a good fit. Knee braces, especially the good quality ones will not only cover your knee but also extend towards the thigh and ankle. The material is of importance here. since you will be wearing it for a long period of time, check whether the material is compatible with your skin and the kind of activity you are involved in on a daily basis.

There are different kinds of braces. Some have Velcro straps, while some use other kinds of fastening mechanisms. It is useful to try the brace on and off a few times to see what kind of style will suit your usual kind of clothing.

If you pick the right kind of brace, you can be certain of painless and quick healing of your knee.

Pain Below the Knee Cap and in Front of the Knee With Walking and Running


Knee cap pain and pain on the inner side (medial) of the knee are common among women. Women with patellofemoral pain syndrome often notice pain below the patella, on the side of the knee or in the thigh and clicking with squatting, going up and down the stairs or getting up after sitting for a while.

In this part of my knee pain series, I'm going to talk about patellofemoral pain syndrome. A rose is still a rose by another name; whether it's patellar arthralgia, patellofemoral tracking disorder or patellar malalignment subluxation, they're the same.

To fully appreciate your knees and understand the pathology of patellofemoral pain syndrome, you need to know how your knees work. So, put the kids to bed and pop open a couple of brewskies.

The entire quadriceps muscle and patellar tendon are anchored to the knee cap. Your knee cap (patella), sits above a femoral sulcus. When you bend and extend your knees such as walking or going up and down the stairs, the knee cap glides up and down along a groove. When you sit down and enjoy that brewskies, I mean milk, the patella slowly sinks back into the sulcus. And when you get up from sitting down for a while, the knee cap has to unlock itself to get out of the sulcus before sliding up the femoral groove.

Patellofemoral pain syndrome does not come over night, even though you may recently experience pain, swelling or clicking below the knee cap, on the side of the knee or in the thigh with squatting, going up and down the stairs or getting up after sitting for a while. It takes time to develop patellofemoral pain syndrome. And by the time it's diagnosis, there's already some wear and tear thinning of the cartilage underneath the knee cap from repetitive the grinding stress and abnormal tension on the patella.

With the exclusion of structural hip and knee deformities such as hip coxa valga or vera or severe bow-legged and knock knees, patellofemoral pain syndrome is basically a pathomechanical problem. You develop patellofemoral pain syndrome when the knee cap cannot properly and smoothly glide up and down the femoral groove. This may due to improper alignment and dysfunction between the knee joints and the patella, weak and imbalanced knee muscles or a high knee Q-angle.

As the patella continues to glide improperly and out of alignment within the femoral groove, the knee becomes irritated and inflamed with pain, swelling, clicking and stiffness; various knee muscles become imbalanced and weak from uneven tension and pulling. Earlier, I mentioned that the entire quadriceps muscle and patellar tendon are anchored to the knee cap.

The cartilage on the underside of the knee cap also begins to wear thin from the stressful grinding and tension. Eventually your knees become degenerative and develop osteoarthritis.

If you experience knee cap pain and pain in front and on the inner side of the knee, swelling, clicking and stiffness, please consult with a chiropractor. It may or may not be patellofemoral pain syndrome.

Treatment of patellofemoral pain syndrome should begin with conservative care before radical treatments such as cortisone injection and surgery. And chiropractic treatments are tremendously effective in treating patellofemoral pain syndrome.

Chiropractic adjustments and soft tissue treatments to the knee joints, patella and muscles relieve pain and stiffness below the knee cap, on the side of the knee or in the thigh. The treatments also restore proper joint biomechanics and muscle functions which give you more mobility and better knee range of motion so you can rotate, bend and extend your legs with less stress to the knee joints while doing rehab exercises.

A vital part in treating patellofemoral pain syndrome includes specific rehab exercises for the weak and imbalanced knee muscles. Weakness to the vastus medialis oblique and adductor magus muscles or tightness vastus lateralis, iliotibial band, tensor fasciae latae and the lateral retinacula can pull the knee cap out of alignment as it glides up and down the femoral groove and place unwanted tension and grinding stress.

It's extremely important to understand the varying amount of compression forces endure by the knee cap, knee joints and muscles at different ranges of knee motion. General knee exercises do not take this into consideration can lead to bursitis and tendonitis. And if the rehab exercises are not task specific and applicable to daily activities, then why are you doing them?

Thursday, February 13, 2014

Knee Surgery: Safe Way For Knee Replacements


Knee replacement is a surgery for people suffering with severe knee damage. It can relieve pain and allow you to be more active. Arthritis is the most frequent cause for discomfort and chronic knee pain. Knee arthritis is the leading cause of disability in the US. In fact, a recent study showed around 1 in 5 people in the United States have some form of arthritis and two-thirds of the people who have been diagnosed with arthritis are under the age of 65.

At the time of the surgery, a damaged cartilage and bone from the surface of knee joint is removed by the surgeon and is replaced with a man made surface of metal and plastic. The process related to the surgery is given below.

Before and during the surgery

In the weeks before you enter the hospital, the orthopedic surgeon will order tests to make sure that you are healthy enough for the surgery. These include:
• Blood tests to measure the red blood cell count
• ECG to measure heart
• Urine tests to check for infection and pregnancy
• X-rays to check the lungs

Before the knee replacement surgery, the anesthesiologist reviews medical chart and discusses the anesthesia appropriate for your situation. There are two types of anesthesia used during the knee replacement surgery. One, where a patient is put to sleep, is known as general anesthesia, and regional anesthesia, where the patient's leg is numbed, either from below the waist or down from the hip. The type of anesthesia given depends on the patient's situation and the doctor's recommendations.

During your knee replacement surgery, the surgeon removes the worn surfaces at the end of the thigh bone using special instruments. The surgeon prepares the top of the shinbone (tibia) in a similar way as the original one. A new metal tray is planted on top of the remaining bone after removing the worn surface. A hard plastic spacer is held by the tray that becomes the new shock absorber between the smooth metal coverings. The back of the kneecap could also be replaced by the surgeon with a new plastic surface.

Surgery comes to an end after the surgeon closes the incision with stitches or staples, when the implant is in position and all the supporting muscles and ligaments are working well. When the surgery is over you are taken over to the recovery room.

Age, weight, activity level and other factors determine the performance of knee replacements. There are certain risks, and recovery takes time. People who are not able to rehabilitate properly should not have this surgery. An orthopedic surgeon is the right person to guide you.

5 Simple Home Exercises After Knee Surgery


Once you return home after knee surgery, it is when your recovery officially starts. You need to start performing muscle strengthening exercises to build up strength that was lost due to injury. Not only that, you will also need to regain your full range of motion in the shortest possible time to eliminate any possible complications. It will be difficult initially as you have lost most of the strength previously. Recovery is a long and tedious process that needs to adhere to a schedule religiously. Deviating from it can possibly cause more harm. Rushing through it will also cause more harm than good. So what are some of the simple home exercises that you can do to help you out?

Ankle pumps

Ankle pumps will help to increase ankle dorsiflexion and help build up the shin muscles. Bend your ankles upwards and pull the toes towards you and subsequently away from you. Hold in each position for 10 seconds and repeat for 3 sets of 10 each time. Aim to perform it 3 times daily.

Assisted leg extension

You will need to regain your full range of motion in the shortest possible time. It is also the top priority post surgery. Lie on your stomach with your leg in full extension. Place you good leg below the injured leg and slowly bring it up. Try to bring it beyond the point of pain and hold in the position for 10 seconds. Slowly bring down both legs and repeat. You should try to do this exercise throughout the day whenever possible.

Seated leg extension

This is also another knee flexion exercise that helps to regain range of motion. Sit down on a chair with a back support. Slowly bend your injured knee back to the point of pain and hold for 10 seconds. Slowly return back to the starting point and repeat. Also when possible, try to perform this exercise throughout the day.

Seated leg kicks

Sit down on a chair with a back support. Stretch out your injured knee as much as you can and hold in the position for 10 seconds. Slowly bring back to the starting position and repeat. This exercise will also help to reduce any scarring in the knees and improve the range of motion.

Quad sets

Sit down at the edge of your beg with your legs on the floor. Try to tighten the quad muscles and straighten your legs concurrently. You should be able to feel your quad muscles contracting. Hold it for 10 seconds and relax. Aim to perform at least 100 sets of this exercise daily as it can help to strengthen and firm up the quad muscles to help shield some of the load from your knee.

Recovery from knee surgery is a slow and tedious process. However, do not feel disheartened and aim to do it slow and steady. Do not be frustrated by it and try to rush through it. It will do more harm than good.

A Stiff Knee in the Morning - Does it Have You Waking Up on the Wrong Side of the Bed?


How do your knees feel in the morning?

Do you have pain when you wake up, or does the pain come on during the A.M. hours?

If you suffer from a stiff knee in the morning, you may have the onset of osteoarthritis, a condition that commonly affects the knees and causes the deterioration of the joint. Osteoarthritis is an incurable condition that can strike anyone at any age, although it is more common in older individuals.

Here are a few things you should do if you have a constant stiff knee in the morning:

1.) Talk to your doctor
2.) Maintain a healthy weight
3.) Stick with an anti-inflammation diet
4.) Remain active
5.) Take painkillers when needed
6.) Wear a knee brace when active

While you cannot cure osteoarthritis, you can ease the pain from this condition as well as keep yourself active longer. Osteoarthritis is not a life threatening condition, although it can be crippling. If you experience a repeated stiff knee in the morning, you can stave off the effects and symptoms of this condition by taking the right steps.

Talk to your Doctor

Only your doctor can diagnose osteoarthritis. You should not make the mistake of trying to diagnose this condition on your own. Your doctor will most likely do a clinical examination, ask you some questions and ask you to do an x-ray or MRI. This is nothing to be alarmed about and can help give you a firm diagnosis.

Maintain a Healthy Weight

If you are overweight, you will want to trim down in order to keep the stress off your knees. Most people who experience a stiff knee in the morning do so because they have osteoarthritis and are overweight. Maintaining a healthy weight can keep the stiff knee from acting up and keep inflammation down.

Maintain an Anti-Inflammatory Diet

There are certain foods that are high in fiber and antioxidants, such as fatty fish and nuts that are good for conditions that cause inflammation, such as osteoarthritis. By eating an anti-inflammatory diet, you can help keep this condition in check. Because the foods that are included in an anti-inflammatory diet are good for you, this will also most likely help you manage your weight. Remember, the healthier you are the more fit you will be and the better you will respond to treatment.

Remain Active

If the doctor has diagnosed arthritis or osteoarthritis of the knee, then it is important that you remain active. (Speak with your physician about the best ways to remain active.) While you may be tempted to stay off the knee because of pain, this may not help the condition and can hasten joint deterioration. Swimming and walking are two good exercises that can help your knee. Wearing a knee brace and proper shoes will help. Braces can really help you maintain proper knee alignment and the support that they provide can really help reduce your knee pain.

Take Painkillers but Only When Needed

Painkillers can be addictive and cause a tolerance in the system. Moreover, pain killers can hurt your stomach. You should only take this kind of medication when absolutely necessary and if the pain is unbearable.

Wear a Knee Brace

A knee brace will support your knee by helping to keep it straight. Although even walking can be painful, becoming inactive because of osteoarthritis can worsen the condition. An affordable and low profile brace can help keep your knee from getting stiff and can help give you instant relief from the pain.

If you believe that you can benefit from pain reduction and increased stability due to the symptoms of osteoarthritis then you should consider a knee support today. Many OA or "unloader" knee supports can be very effective.

ACL Tear Treatments - ACL Surgery


The ACL or anterior cruciate ligament is one of four key knee ligaments. The ACL attaches the tibia to the femur, keeping the shin bone in place, and is critically important to knee movement and stability. An ACL strain or tear is one of the most common knee injuries and individuals who have suffered an ACL injury often complain that their knee "gives out" or buckles as the joint's overall stability has been compromised.

While there are many, many ways to tears one's ACL, the most common is high impact sports where the knee is forced to make sharp movements. High probability sports include football, skiing, rugby, and soccer. 80% of ACL tears occur in a non-contact situation where the knee is simply pushed beyond its capabilities. The other 20% result when there is a direct impact from another player or players. Research has also shown that women involved in sports are far more likely to sustain ACL tears than men. This is likely due to weight distribution and how the female hips situate the knees.

How Can I Tell if I Have Injured My ACL?
ACL injury's result is pain, swelling and knee instability. A physician or sports doctor can either conduct special tests or an MRI to decide the degree to which the ACL is injured and if other ligaments where torn as well. It is quite common for multiple ligaments to be injured simultaneously. An ACL injury can lead to significant long-term knee instability and for this reason, many seriously injured individuals opt for surgery. ACL Surgery is certainly not required, however. Torn ligaments, including the ACL, can heal on their own and some individuals prefer physical rehab rather than undergoing the knife.

Should I Have Surgery for My ACL Injury?
If you have a complete tear, it is very likely that surgery is your best option, but if you have a partial tear, you will need to evaluate your situation and decide whether or not surgery is right for you.

There are several things to consider when evaluating ACL surgery, including:

  • What is the extent of your injury? Is it a small tear or something more substantial? The more extensive the injury, the longer non-surgical rehabilitation will take.

  • How important is a healthy ACL to your lifestyle? Do you play high impact sports? Are there certain activities that are critical to your quality of life that you are not willing to give up, such as skiing or soccer?

  • After several weeks of recuperation, does your knee feel "normal" or do you experience knee instability? Does it cause you pain or significant anxiety? Does it impede your ability to do important activities?

What to Expect with ACL Reconstruction
The surgery for an ACL tear is called ACL reconstruction. It is a procedure done under general anesthesia, meaning the patient is "asleep" for the operation. The surgery replaces the damaged ACL with healthy tissue from elsewhere in your body (autograpgh) or a donor (allograft), usually using tissue from the knee cap or hamstring tendons. The procedure is executed with a tiny knee arthoscopy camera which the surgeon will use to observe and treat the affected area. The new tissue is usually attached with screws or similar devices. After the surgery is complete, the patient will need to wear a post-surgical knee brace to support and stabilize the knee during rehabilitation.

ACL reconstruction surgery is fairly common and usually quite successful (90+%). There are, however, risks associated with any major medical operation. For ACL reconstruction the risks include infection, stiffness, the continuance of instability or pain, and difficulty performing certain tasks.

After surgery, the patient will undergo a rigorous rehabilitation period. Rehabilitation focuses on returning range of motion and building of muscles to support the knee and prevent future injury. It is recommended that the patient continue to strengthen their leg muscles as it will provide the best long-term knee stability. Many patients also choose to wear an ACL brace when they engage in at-risk activities -especial sports.

The Benefits Of Acupuncture For Diagnosis And Treatment Of Arthritis


Acupuncture for diagnosis and treatment of arthritis is now becoming more prevalent but having your skin savagely poked with a series of long needles doesn't exactly sound like ideal comfort, especially when you are already living with arthritis, a rheumatoid disease characterized by it's trademark stiffness and pain. The ancient Chinese would beg to differ, along with the estimated fifteen million Americans who have tried the ancient Chinese needle therapy known as acupuncture. Around the Asian continent, acupuncture has been used for generations to alleviate the symptoms of chronic pain sufferers, like arthritis patients, for instance. Prospective "acupokees" should be aware that acupuncture therapy is used for treating arthritis, not diagnosing it. Although patients should garner a arthritis diagnosis before signing up for acupuncture therapy.

Studies in Arthritis and Acupuncture

More than twenty million Americans live with osteoarthritis (there are various forms of the condition, however). In fact, osteoarthritis is amongst the most frequent causes for physical disability in adults. Despite a history spanning more than two thousand years, it was 2001 before acupuncture was found to aid arthritis in the knee via a study by the University of Maryland School of Medicine. The study included 570 osteoarthritis patients over the age of fifty who had never before received acupuncture, surgery, or steroid injections. A control group was selected and these individuals received regular sessions of acupuncture. By the end of the first week, the acupuncture group experienced a surge in mobility and by the end of the study the group reported a forty percent decrease in pain and a forty percent increase in knee function.

Using Acupuncture For Treating Arthritis

Bigwigs of Western medicine aren't exactly sure just how acupuncture works to fight arthritis and similar diseases, but the skilled acupuncture who administer the therapy have an idea or two. According to therapeutic philosophy, pain is the result of a blockage of one of life's essential energies, qui. Stimulating certain points will put the flow of qui back in balance again, thus alleviating chronic pain in the process - Volia! A 1999 study even found evidence that acupuncture improves sleep.

During acupuncture therapy, very thin needles are inserted into precise point in the skin, these points are known as acupoints. It is these acupoints that may have the biggest influence on the connection between treating arthritis with the use of the acupuncture therapy. In addition to being poked and prodded, acupoints also react to magnets, currents of electricity, acupressure (hand pressure), lasers and even bee stings. Acupuncture practitioners have also been known to administer herbs along with wielding out some advice on making lifestyle changes at the conclusion of a session.

Studies demonstrate that some of designated acupoints are actually connected to sensitive bio-trigger points rich in nerve endings. And further studies show that tinkering around with those triggers can cause a mirage of biological responses, one of the many responses being the chemical release of endorphins. The release of endorphins is pivotal to acupuncture's influence on arthritis because the chemical serves as the body's own answer to Advil, Tylenol and Motrin, as a natural painkiller.

Acupuncture Checks and Balances

Acupuncture costs vary across the United States. But as a rule of thumb, first visits usually fall between $75 and $150, with cheaper follow-up treatments costing between $35 and $75. Health insurance accommodations of acupuncture vary, but advocates of using the therapy for the treatment of diagnosed arthritis cite the long-term benefits of it's hefty price tag, which include fewer doctor visits over time and saving a few bucks on prescriptions.

Sharp Or Shooting Knee Pain When Climbing Stairs? - Painful Knee Joints and the Benefits of Braces


Do you ever wish you could climb the stairs with ease, like other people seem to do?

Do other people get frustrated with you when you want to take the elevator, instead of taking the stairs? Maybe one flight of stairs might not be a problem for them, but for you it might be a larger problem...

If you look at a stair climber at the local gym, do you start to think about how you could never use that piece of equipment?

Introduction: If you have knee problems related to climbing the stairs, then you are definitely not alone. You might feel OK while you stand or walk, but when you begin climbing some stairs, then that sharp knee pain might kick in! - So now what? - You know you do not want it to stay like this all your life!

1.) Sharp Knee Pain

Knee problems when walking up a flight of stairs can be a serious issue. This might even be an understatement for some of us that have knee pain issues. You might have a degenerative knee issue or another type of knee ailment that is causing the pain, and this can become a constant source of frustration for you...

2.) Self Diagnosis

While we recommend that you speak with your physician about medical advice, a person can still ask themselves some important subjective questions. First, you can evaluate for yourself how intense your knee pain or instability is... You are probably going to be the one to know that you have a knee problem before your doctor does and a quick evaluation about knee pain and instability levels can start to get you on the right track.

3.) Climbing Stairs: Knee Braces For Support, Pain Reduction & Protection

When you climb stairs, you can usually benefit from the use of a well designed knee brace. The support that one of these braces can provide can help you to reduce your knee discomfort and feel more stable in every step you take. - The good thing is that knee supports these days are not very heavy or cumbersome. They do not have to be bulky to be strong or effective for you. You should seriously consider supporting your knees if you have knee pain or instability before, during, or after climbing a set of stairs. They can be a conservative treatment option that can make a big difference for you!

Wednesday, February 12, 2014

Understand Knee Rehabilitation


James had injured his knee on a rambling trip in France. After consulting his family doctor he was advised to work out on an exercise bike. This just made the knee worse so he consulted a second doctor who sent him for physiotherapy. The physiotherapist referred him to a gym, where the fitness manager put him through a rigorous programme of exercise with a rowing machine, treadmill and cross-trainer. Imagine his misery when instead of the knee getting better it swelled up, became much more painful and he found himself wondering if he should buy a walking cane and move to a downstairs apartment. What was going on?

Well, knee rehabilitation after injury or surgery is not just a case of going to the gym and pushing through the pain. In this case, none of the medical people had made a proper diagnosis, but even without a diagnosis the knee itself was making it clear that the exercise regime was inappropriate.

You see, the body follows a natural progression of healing. Each step of the rehabilitation programme needs to be in sympathy with this healing process. If not, one can do a lot of harm.

After any insult to the knee the inflamed joint lining produces increased fluid and a cascade of chemicals that appear one after the other in a specific sequence. The early part of this cascade encourages blood vessels to dilate and become leaky. Blood plasma containing immune cells leak out of the blood to enter the damaged area and try to clean it up and prevent infection. This whole process contributes to the knee feeling swollen, hot, red and painful. This is called inflammation. Different chemicals emerge later in the cascade to promote closing up of the injury and enhance healing through formation of scar tissue to replace damaged or missing tissues caused by the original injury.

If the knee keeps getting stressed, then the choreography breaks down and the inflammation cascade occurs at the same time as the scarring cascade. This can sometimes prove disastrous, with a hot swollen painful knee stiffening up with sticky adhesions within the knee cavity and the lubricating pouches around the knee, tying previously mobile tissues together and reducing movement within the joint. Without the right attention these adhesions can turn into scar tissue.

To give your knee the best chance of benefiting from a rehabilitation programme you must clearly identify what phase of rehabilitation your knee is in. You need to know what the phases are and the dos and don'ts of each phase. You need to be able to recognise when you have pushed things too far for that phase and what to do about it if you do.

In the early stages of rehabilitation after injury or surgery be sensitive to the fact that the knee lining is likely to be inflamed. The swelling and pain that are normal in this phase may cause the muscles, especially the quads muscles, to become inhibited and unable to contract properly. Gentle sustained stretches ensure that the tendons of the inhibited muscles do not shorten and limit movement in the future. Gentle progressive movement is necessary and really important to lubricate the joint properly and to break down any adhesions. Simple 'balance' exercises improve balance and position sense in the knee, both of which can easily be lost at this stage leading to re-injury. Rest, ice, compression dressings and elevation are needed after each session to try and minimise swelling. While the inflammation settles you may have to limit some activities and then build these activities up again gradually during the later healing stage.

Only when you have close to full range of movement should you start to concentrate on rebuilding strength. Keep in mind when starting strength training that muscles act in complementary sets. For example, you need to exercise the muscles that bend the knee as well as those that straighten it. Too much emphasis on one set of mucles may lead the complementary set to weaken which destabilises the knee. The quality and timing of the muscle contraction is also important in re-building muscle strength efficiently.

Under ideal conditions, rehabilitation would progress smoothly from strength training to endurance training and then back to full activities. But moving to endurance training too early can again trigger an inflammatory response and set rehabilitation right back with more swelling, pain, muscle inhibition and loss of the range of motion you may already have regained. This is what happened in James's case. He had already lost time off work, and had now wasted all his efforts in going to the gym.

In this scenario, pushing through the pain is not going to fix the knee. It will only make things worse. With knees, repeating cycles of healing and then renewed inflammation signify that you are pushing too hard and are not being careful enough in your rehabilitation programme. Back off right down again to the first stage of rehabilitation. Return your focus to dealing with the inflammation not the strengthening or endurance. While that might seem like a step backwards, it is really a step forwards towards your ultimate goal of getting better.

Start again with rest, ice, elevation, compression, and possibly anti-inflammatory medication. Stretches and gentle flexibility exercises should be continued, but only when the inflammation settles should you return to strength and endurance training. If you cannot manage this on your own, a good physiotherapist with experience in knee rehabilitation should be able to resolve the problem before things deteriorate too far.

Knee Brace for Sports - A Review of Selection Criteria


A knee brace is a device that is worn around the knee joint to help provide support and/or alleviate pain/discomfort. Braces can vary considerably in their design from a simple elastic 'one size fits all' sleeve to custom made activity specific hinged mechanisms. There are a huge number of braces available but they can be separated into 3 identified categories:

• REHABILITATION
• PROPHYLACTIC
• FUNCTIONAL

Rehabilitation braces are designed to protect an injured area while waiting for healing to occur. They completely immobilize or restrict movement around the joint and as a result are larger and more cumbersome than other braces. Typically rehabilitation braces are prescribed by a health care professional according to the type of injury and degree of protection required.

Prophylactic braces are worn to prevent knee injuries from occurring. They are often worn in contact sports such as soccer although the available evidence is inconclusive as to exactly how effective they are at preventing injury.

A functional brace is worn to provide support to a knee that has been injured and as a result has some sort of structural or stability deficit. Functional braces can help to reduce pain and reduce risk of re-injury. The evidence suggests that while a functional brace takes time to get used to, they do not hinder performance. Most people considering a brace will be looking for a functional brace but the array of choice can be confusing.

The appropriate selection of a brace will depend entirely on the purpose for which it is intended. When choosing a brace there are several factors that you must consider:

• THE TYPE OF INJURY THAT YOU WANT TO PROTECT
• THE SPORT/FUNCTION THAT YOU WANT TO USE IT FOR
• THE AMOUNT OF MONEY THAT YOU WANT TO SPEND

Knee Braces by Type

Hinged Braces
Hinged braces are usually more robust than other types. They restrict lateral (side to side) movements and can also be used to limit the amount of flexion (bending) or extension (straightening) at the knee joint.

Neoprene Braces
Neoprene is a thick stretchy material which will stretch in all four directions. It is a commonly used material in knee braces and is very versatile. Neoprene braces can come in the form of a simple sleeve, with added support around the knee cap, in a wrap around design for a more contoured fit, or with added lateral rigidity.

Elastic Braces
Elastic braces are made of stretchable fabrics and are generally considered to be very comfortable. They are typically only used for light support in very mild injuries.

Knee Bands
Knee bands are usually much smaller than other braces and are typically used only for tendon and bursa problems. They wrap around the painful area to 'offload' stress through the injury. Knee bands are fairly uniform in their design a good range are available.

Knee Braces by Injury

Arthritis
Arthritic or degenerative conditions will benefit from a wrap style brace providing compression and support. If the patelofemoral joint is affected, a cutout brace which stabilizes the patella (kneecap) should be considered. For arthritis within the knee joint itself an 'unloader' brace should be considered.

Ligament Injuries
Ligament injuries will benefit from a more dynamic, hinged brace. Collateral ligament (MCL or LCL) should be limited from any lateral (side to side) movement but still allowed to fully flex and extend. An ACL injury (either surgically repaired or non-surgically managed) can benefit from a similar sort of device but may further benefit from a knee extension constraint brace. A knee extension constraint brace is a type of hinged brace, it limits lateral movement, prevents twisting and reduces loading on the ACL. The DonJoy custom defiance brace is used for ACL injuries and is made to measure which helps with comfort and function.

Meniscus Injuries
Mild to moderate meniscus injuries can be helped by a compression/wrap around brace. A more significant injury or tear will require a hinged brace which limits twisting/turning type movements.

Once you have chosen the type of brace you need, it is also worth thinking about how long and what activity you are likely to need the brace for. If it is for short-term and light use only then a generic 'off the shelf' device is likely to be sufficient whereas if you are likely to need the brace for long term or heavy duty use (as is often the case with ACL injury or repair or activities which require a lot of impact/twisting & turning) then a more long lasting made to measure brace would be better.

Skiers in particular need to consider how the design of the brace will affect their activity. ACL tears are commonly associated with ski injuries. Assuming that a good recovery has been made, there is no reason why a full return to activity should not be made. However, most skiers will require bracing following repair and rehabilitation, especially high level aggressive skiers. Bracing manufacturers have designed braces specifically for this purpose. One example is the DonJoy Ski Armor.

An inappropriately chosen knee brace can cause more harm than good and the decision to use a brace should not be taken lightly. The most important factor in choosing a knee brace should be based on an accurate diagnosis of your injury. If you are in any doubt over this then you should seek advice from a registered health professional.

While Purchasing Walking Aids


What is the best gift you could give a person who is disabled to walk on his or her own? Definitely, an aid to move about independently! The goal of walking aids is no different as they come proficient to make a disabled person capable of moving. Walking aids, in fact, are becoming more and more common with the number of people who are suffering from kinaesthetic disabilities increasing day by day.

Walking aids are used by many people for many reasons, such as, old age, arthritis, joint replacement, limb surgery, hip or knee pain and so on. This aid helps the user put some weight on it and thus reduce the pressure on the legs. It helps in supporting and balancing the user's posture and enables him to walk without help from another person.

Walking aids come in different types, starting from the early walking stick that was used by old people since centuries. However, with the lifestyle of people changing and moving to a faster pace, aids to help in mobility also changed their forms and now come in more complex forms like walkers, crutches, wheelchairs, power scooters, rollators, etc. Each of these comes with more and more options to make movement easier for its users.

Buying walking aid for one of your loved ones is a good idea, depending on how that person would look at it. In fact, you need to be very careful when you are buying an aid for someone else. It should not offend that person, as there are many people who might consider using a walking m aid as losing their freedom or who are just not able to acknowledge that fact that they need support to walk. However, when the next option is to depend on a nurse or a maid, the walking aid is undoubtedly more attractive.

Once you decide on purchasing a walking aid, the next factor to consider is the budget. This come in different prices, based on the technology used to make them. Naturally, that would mean that simpler aids would cost lesser while more complex ones are more expensive. Another factor is the existing capabilities of the person who you are buying for. If that person cannot move his upper body as well, there is no point in buying a walker or a walking stick. A wheel chair is more suitable for such a person. In other words, the main factors to consider while purchasing a walking aid is the requirements of the user and the price and quality of the aid.

Where to purchase walking aids from is the next point to consider. Well, the good news is that you need not go around visiting shop after shop checking out different products. With so many online stores now, all you need to do is a little browsing and collect all the necessary information regarding the product that you are planning to buy. Within a few days, the item that you chose would reach your home, thus making the user happy and easing your efforts.

Arthritis And Pain Relief - Preparing For Ski Season


You can ski with arthritis, and many people do. If you have rheumatoid arthritis, fibromyalgia, or other autoimmune disorders, getting ready for ski season requires more than your typical fitness conditioning.

Focus first on overall fitness. Condition yourself for the sport of skiing with a variety of leg exercises and upper-body toning. As you train, remember to progress slowly through a program. You might need more than the usual 6-8 weeks of physical preparation time.

Consider the weather elements and ski slope conditions. Your environment will affect *how you ski,* how your body feels about its new challenges, and* how quickly you will recover from your skiing activities. Do you have enough clothing that you can layer for cold, windy conditions or for bouts of sweat as your muscles warm up?

There are many types of arthritis and chronic conditions that zap your energy and make your muscles ache. Two important characteristics of these disorders will influence your skiing experience. For better skiing adventures, align your fitness conditioning with these in mind.

Your immune system activity is one of these influences that can adversely affect your skiing. Autoimmune responses are a factor in these types of conditions. Your immune system may be working overtime, inadvertently attacking healthy tissue. When you focus on the immune system in your preparation, you want to avoid taxing the immune system or increasing its stimulation.

If you get sick, like with a cold or flu, recover completely before skiing. If you get sick while participating in a ski conditioning fitness program, discontinue the program and allow your body to rest and heal. As you recover from illness and resume your program, avoid jumping back into it with the same intensity as before you got sick. Progress cautiously.

Avoid toxins and chemicals as you prepare to ski. Surround yourself with natural products in your house and work.

Eat natural foods that are free from chemicals like artificial sweeteners, preservatives, and hormones. Minimize your dairy and meat intake in your diet and increase your consumption of organic vegetables. As tempting as those ski resorts and towns can be, avoid heavy alcohol or super-rich decadent foods and opt for fresh salads and seafood. Stay hydrated!

The other factor that will influence your body's reaction to skiing is inflammation. Arthritis represents an inflamed physical state (hence the suffix, -it is). In healthy individuals, some inflammatory response to muscle conditioning is good for you. Your muscles will grow and get stronger with new physical challenges.

However, if your body is already in a chronic state of inflammation, your muscles recover differently. Throughout your ski conditioning, and then as you begin to ski, practice active rest to reduce inflammation and speed recovery. Active rest enables your body to recover faster than sleep or inactivity without exerting effort. Types of active rest include sports massage therapy, mild body treatments like salt scrubs and seaweed wraps, meditation, sauna, and ice applications.

In conclusion, if your body feels challenged to ski with arthritis, use extra time and focus in your skiing preparations. Your body will enjoy skiing more than most winters. Your stamina and recovery will improve. And you will want to return to the ski slopes sooner than ever before!

Total Knee Replacement - Computer-Navigated Orthopedic Surgery Solution in a Tri-State First


Significant recent advances in joint replacement surgery, such as minimally-invasive procedures, require the surgeon to use specialized techniques and instrumentation. Computer-assisted orthopedic surgery (CAOS) is a market whose growth is spurred on by the evolving surgical process and the surgeon's goal of ensuring the best patient outcomes. More precise placement of the implant means a longer-lasting joint, greater likelihood of restoring normal mobility, and a better quality of life for the patient.

On January 15, 2008, Dr. Michael J. Greller and fellow orthopedic surgeon and colleague Dr. Alan S. Nasar of Freehold, New Jersey, performed total knee replacement surgery using a fully cementless trabecular metal knee, assisted by a powerful, new, computerized navigational tool. This was the first time in the Tri-State area that an advanced navigation system was used to guide the precise alignment of the trabecular knee implant and ensure optimal movement and balance.

The total knee implant was the preferred joint replacement surgical option for a young, active, male patient and was performed at CentraState Medical Center in Freehold. Dr. Greller explained that the shorter incisions of minimally invasive surgical procedures used by the orthopedic surgeons at Advanced Orthopedics and Sports Medicine Institute reduce the visual access needed to position implants precisely. Computer-assisted orthopedic surgery uses computer imaging and tracking to guide the placement of the implant. Correct alignment of the implant with the upper and lower leg results in the best patient outcomes, fewer post-operative complications, less pain, less medication, and faster recovery. Implant misalignment, even if only by a few degrees, requires some patients to have additional surgery within a few years, either to reduce discomfort or to replace the worn implant. For most patients, the most dramatic benefit of a perfectly aligned implant is the return to normal mobility and an improved quality of life.

The navigation system software that performed so well for the surgeons provided implant-sizing information that allowed them to use the specific implant preferred for that particular patient. It assisted in determining the mechanical and rotational axis of the leg, ensuring exact placement of the implant. Dr. Greller praised the arrival of such an improved navigational system. "Once the system was set up, it functioned flawlessly throughout the case and required no adjustment or fine tuning. The computer was able to learn the patient's anatomy in a few steps. The disposable reflectors called 'Navitrackers' are proprietary to Orthosoft, who developed the system, and replace the sometimes cumbersome spheres on other navigation system instruments we have used. The final result of the case was excellent. The x-rays looked perfect and the alignment was exact. The knee had great motion and was well balanced. We were able to implant the knee accurately with as few extra steps as possible."

This particular protocol is not for every patient. Every candidate for joint replacement surgery must be evaluated individually, considering various advanced components and techniques. The Zimmer trabecular implant was chosen in this instance for its superior resemblance--physically and mechanically--to healthy bone and its porosity which allows for greater bone in-growth. When guided into place with the assistance of the navigational software, the trabecular implant is allowed a bond to bone without cement, precisely placed, to ensure an excellent outcome for this particular patient. The patient's recovery is typically remarkable: faster recovery time and improved mobility. As advancements such as these used in this Tri-State "first-of-its-kind" knee surgery continue, fewer and fewer patients should have to live with knee pain.

ACL Surgery Recovery


Your knees and ACL can take a lot of stress through their life. Once of the most common problems with knees that people need to get fixed is anterior cruciate ligament ACL surgery. Some of the other most common knee problems include cartilage/meniscus damage, arthritis and other ligament strains.

When someone needs ACL surgery the rehab process can often be long and painful. Here is the general surgery recovery timeline for and ACL reconstruction.

Anterior Cruciate Ligament Surgery Recovery

Immediately Post Operative - Two Weeks

The ligament is the weakest at the 6 weak mark however that doesn't mean you cant be moving before then. By the end of the first week people can be walking slowly. The goal during this phase of the recovery is to

  • Reduce swelling

  • Increase range of motion

  • Begin quadriceps and hamstring strengthening

Some of the exercises that are done during the first two weeks include quad sets, heel slides and prone knee flexion.

The second stage of knee surgery rehab is from 2 to 12 weeks

The goal during this phase is to return full range of motion and regain balance. Full knee extension and flexion to over 130 degrees are critical. You should be able to walk without crutches and do full squats properly. Some exercises in the second phase of knee surgery rehab include sit/stands, leg press, fixed position lunges and squats.

3-6 months after ACL Surgery

Recovery from anterior cruciate ligament surgery in the 3-6 month period includes sport specific drills to help people return to sports. Often these can include cutting drills, jumping drills and single leg balance drills.

Final stage of recovery - 4th stage - 6-12 Months

In the final stage you will be able to return to normal activity. The drills are finally at full speed and include full speed cutting, vertical jumps, hop tests and other intense sport specific drills.

Watch an ACL surgery recovery timeline

Tuesday, February 11, 2014

About Vitamin D


Introduction

One of the fat-soluble vitamins, vitamin D constitutes two major forms which are vitamin D2 or ergocalciferol and vitamin D3 or cholecalciferol. Vitamin D2 is synthesised by plants whilst vitamin D3 is synthesised by the body. Vitamin D is naturally present in a number of food sources and dietary supplements, and is also manufactured with the aid of sun exposure. It is produced within the body when ultraviolet-B or UVB rays from sunlight reaches the skin. The liver and the kidney eventually help to convert vitamin D to an active hormone form.

Functions of Vitamin D

Vitamin D plays several key roles in the maintenance of organ systems. For example:

* Vitamin D helps regulate calcium concentrations in the blood. Since it works more like a hormone, its active form, calcitriol acts with the parathyroid hormone or PTH. If the calcium level is low, this would trigger the secretion of PTH, which would stimulate the conversion of vitamin D to calcitriol. Calcitriol would then act to increase calcium absorption in the intestines, calcium resorption in the kidneys and stimulate calcium release from the bones.

* Vitamin D helps maintain blood phosphorus levels. Low levels of vitamin D can result to an overactive parathyroid gland. Also with inadequate phosphorus in the body, bones cannot undergo normal mineralisation.

* It is also said that vitamin D benefits the immune system since the T-cells or immune cells have receptors for vitamin D. It acts by boosting phagocytosis, the bodily functions to combat tumours, modulate neuromuscular and immune functions and reduce inflammation.

* Vitamin D is also responsible for maintaining normal cell growth and function. It may be an important element to the prevention and treatment of cancer. It has also been suggested that vitamin D plays a role in regulating the growth and function of brain cells.

* Research studies suggest that vitamin D, because of its anti-inflammatory effect, plays a role in providing protection against osteoporosis, hypertension, cancer, type 1 diabetes, psoriasis and numerous autoimmune diseases.

Deficiency Conditions

There may be certain underlying causes of vitamin D deficiency. It can result from:

* Inadequate vitamin D intake together with inadequate sun exposure

* Certain disorders that compromise vitamin D absorption

* Conditions that can impair the conversion of vitamin D metabolites such as kidney or liver diseases or hereditary disorders.

Insufficient vitamin D intake can have serious effects on the bones, which can make them thin, brittle or deformed. Vitamin D deficiency often results in conditions like:

* Rickets which is common in children and is characterised by delayed growth and deformity of long bones.

* Osteomalacia, which occurs in adults and results in thinning of the bones. Signs of proximal weakness and bone fragility are familiar characteristics.

* Osteoporosis which is a condition wherein the bone mineral density is reduced and bone fragility is increased.

Lack of vitamin D may also be linked to increased susceptibility of several chronic diseases like high blood pressure, cancer, tuberculosis, periodontal disease, multiple sclerosis, chronic pain, schisophrenia, depression, affective disorders, peripheral arterial disease and a number of autoimmune diseases such as type-1 diabetes.

Deficiency Symptoms in Adults and Infants

Signs of vitamin D deficiency includes muscle aches, myopathy or muscle weakness and bone pain. These symptoms can occur at any age. Pregnant mothers who have vitamin D deficiency can also cause fetal deficiency.

In younger infants, rickets can produce a condition called craniotabes or softening of the skull. In older babies, rickets can impede or delay sitting and crawling and the closure of the fontanels; bossing of the infants' skull and presence of costochondral thickening or what is referred to as 'rachitic rosary'. Children with rickets aged 1-4 years old experience epiphyseal cartilage enlargements on the long bones and delayed walking. Older children and adolescents can experience pain upon walking and in worst cases it can result in 'bowlegs' or 'knock-knees'.

Tetany that is caused by hypocalcemia may go along with vitamin D deficiency in infants and adults. This condition can lead to symptoms such as loss of feeling in the lip or tongue areas and the fingers, facial spasms, and at worst, seizures.

Recommended Daily Dose of Vitamin D

Doses or intake of vitamin D is determined according to age groups. These amounts are vital to maintain normal growth and bone health and also normal calcium metabolism in the body. The adequate intakes or AIs for vitamin D indicated are based on the supposition that the vitamin D is not synthesized by sunlight exposure.

From birth to age 13, the recommended AI for children is 5 mcg or 200 IU; for both males and females aged 14-50 years old, 5 mcg or 200 IU is needed; for both males and females aged 51-70 years of age, 10 mcg or 400 IU is required; both males and females reaching the age of 71 and up require 15 mcg or 600 IU of vitamin D. Pregnant and lactating mothers need 5 mcg or 200 IU of the vitamin.

Vitamin D Food Sources

Only a few food sources contain vitamin D. Best sources of vitamin D are fish meat and fish liver oils. There are also small amounts of vitamin D, in the form of vitamin D3, found in dairy products like cheese and egg as well as beef and liver. Some types of mushrooms also contain varying amounts of vitamin D2.

Common sources of vitamin D include the following:

* Cod liver oil

* Fish like salmon, mackerel, tuna, sardines

* Milk including non-fat, reduced fat, whole or vitamin D fortified

* Margarine

* Cereals

* Egg

* Beef liver

* Swiss cheese

* Fortified orange juice

* Fortified rice or soy beverage

The Need for Increased Amounts

Since obtaining sufficient amounts of vitamin D in the diet can be quite difficult, many people now consume vitamin D fortified foods in order to maintain a healthy dose of the vitamin. There are some groups however who need increased amounts of vitamin D:

* Breastfed infants because vitamin D cannot be supplied by breast milk alone

* Older people due to the fact that synthesis of vitamin D decreases with age and the ability of the kidney to convert vitamin D diminishes

* People with limited sun exposure especially those living in northern latitudes, those wearing robes or head covers or those with occupations that prevent them from having sun exposure

* People with dark skin as more skin pigments like melanin reduces the ability of the skin to produce vitamin D.

* People with fat malabsorption conditions such as Crohn's disease, cystic fibrosis, liver and celiac disease or patients who have undergone surgical removal of any part of the stomach or intestine.

* People who are obese. An increased amount of subcutaneous fat can snatch more of the vitamin D and somehow alter its release in the circulation.

Interaction of Vitamin D with Prescribed Drugs

Vitamin D supplements have the tendency to react with certain types of prescription medications. These include the following:

* Steroids or corticosteroid medications like prednisone which can cause decreased calcium absorption and also damage the vitamin D metabolism process.

* Weight-loss medications such as orlistat and cholesterol-lowering drugs like cholestyramine also decrease the absorption of vitamin D and other fat-soluble vitamins

* Phenobarbital and phenytoin increases vitamin D metabolism and decreases calcium absorption.

Why Should I Wear a Knee Brace?


There are basically three types of braces: Post-operative, functional and preventative/prophylactic knee braces.

Post-op braces are usually prescribed following surgery or an injury when the knee requires complete immobilization. These braces are usually long braces that may extend from the upper thigh to the lower leg. After surgery or severe knee injury, mild to moderate pain and edema of the knee occurs. Your doctor may prescribe a knee immobilizer which prevents the knee from bending. These devices are used as an alternative to cast immobilization.

The doctor may also prescribe a post-operative brace that has hinges that offer range of motion capabilities. These post-operative braces are innovative, easy-to-use braces that can adjust the range of motion with the click of a button. These braces can immobilize the knee and then allow controlled increases in range-of-motion as the knee heals and the patient begins physical therapy.

There is no controversy with these types of braces, as they have proven effective and efficient as an alternative to cast immobilization.

Functional braces are hinged supports that support and take over the function of damaged knee ligaments in and around the knee. These braces can be fabric style with hinges, or complete metal frames or carbon fiber. These braces are designed to protect the MCL (Medial Collateral Ligaments), LCL (Lateral Collateral Ligament), Meniscus, ACL (Anterior Cruciate Ligament) and PCL (Posterior Cruciate Ligament). You may have noticed some professional football players using these types of braces.

Prophylactic or preventative braces are supports that are used by some athletes that do not have an injury, but prefer to wear a brace to prevent injury, especially in high impact and contact sports like football, rugby, skiing and water sports. This is where we get some controversy.

Many doctors feel it is not only unnecessary to wear a brace to support a normal joint, but may cause harm, as it may affect the biomechanics of the patients gait. Some doctors are also concerned about weakness in the knee joint from prolonged use of knee braces. The more rigid braces will remove stress away from the knee and the surrounding muscles and ligaments and may cause atrophy and loss of bone density.

Many doctors however feel that given the right circumstances, these braces, when used properly, can provide a level of protection for athletes, especially in high impact sports. Some patients with inherited unstable knees can benefit from this type of brace.

It is important that you consult with your physician and therapist before deciding on a knee brace. There are hundreds of manufacturers and thousands of knee braces to choose from, so it can be very confusing. There are braces specific for ACL tears, and ones for patella tracking. If you purchase the wrong brace for your condition, you may not only risk further injury, but may cause other problems.

Learn How to Dunk or 10 Ways to Improve Your Vertical Jump


Let's be blunt about it: if you play basketball, there's two leagues of people - those who can dunk, and those who cannot. Although you might think it's just a question of height, this is not at all the case. Of course, being tall helps, but even average height people - 5ft 9 or 5ft 10 - can learn to perform amazing dunks. How? It's obvious - by improving their vertical jump. Now, there is a lot of ways to skin the jumping cat, but not all are equally effective (and some can actually be rather dangerous). I've put together a collection of tips and tricks that helped me improve my vertical jump from near nothing (after knee surgery on my jump leg and rehabilitation) to over 30 inches within 9 months.

Tip 10) Always warm up before exercise. Trying to push your muscles to the max without warming up appropriately before (with light exercises such as running up or down stairs, or jumping with a jumprope) is a bad idea and can easily lead to strains and other problems.

Tip 9) A basic jumping exercise is the squat with weight. While standing, slowly bend your knees with your back straight. Go down pretty low (you shouldn't feel any pain or be uncomfortable), then slowly go back up. Doing this slow is key for building up quad muscle volume and power. Start without weights and increase difficulty by gradually raising the number of repetitions. People with major jumping power can easily do 100+ such squats. If you hold a weight such a dumbbell or barbell, hold it behind your head,
in one vertical line with your spine.

Tip 8) Separate weight training days from speed/plyometric days. Medical studies have shown that mixing these different types of exercises is actually bad for the results.

Tip 7) Use jumping rope. Although sometimes shunned as "uncool", it is the basic plyometric exercise and one of the best ways to improve the explosiveness and power of your legs.

Tip 6) Never relax and let go during your waking time. During my rehab, I was hell-bent on getting my leg back to the same power level as before, and beyond that. I didn't just exercise every day - I did it nearly
permanently. Of course, you can't do heavy squats or plyometrics all the time because your legs can just do so much until they tire. However, even little things like walking toe-heel style instead of flat-footed, standing on half-bent legs while doing household stuff, or playing with your quads and calves while
sitting, are very effective when done regularly over a long period of time.

Tip 5) Calf exercise. It's not only the big upper leg muscle groups that determine your total jump height. Powerful calves can easily add another couple of inches that you may be missing for a resounding dunk. The basic calf exercise is toe raises: stand upright, raise on your toes, go down, and repeat it 50-100 times. When your calves feel hot and burning, it's time to make a break. A somewhat better variation is: stand on some stable horizontal ledge only with your toes and front part of the foot. Hold yourself at something with your hand. Go down with your heels about 30-45 degrees below the ledge, then push up until you are on your toes. Repeat as many times as you need to tire your calves. Again, key is slow and steady. Don't pump up and down. It may be easier, but the effect is nowhere near the same.

Tip 4) Don't overwork your leg muscles. Our muscles grow best when subjected to a cycle-wise load: a heavy workout, then a day of rest or just light exercise. To push your maximum jumping ability, you need
the large leg muscles to perform at their peak (and beyond). When overworked, they are unable to deliver that performance, and your jump does not improve despite exercising. A sign of overworking is when your leg muscles ache or burn.

Tip 3) Don't just jump mindlessly. Focus on jumping completely. With every jump, aim to leap as high as you can. Scientific tests have shown that persistent focus on a physical activity improves the results by 10-20% on average.

Tip 2) Don't expect results too soon, and never give up. I know several guys who bought expensive plyometric programs or jumpsoles expecting some kind of miracle within a few days. There's no such thing
though, so once they didn't see the quick results, their determination sizzled away and their jumpsoles would sit gathering dust. Although there are good programs around, there's no miracles. The only thing that will radically improve your vertical is tenacity. Exercise a lot. Regularly. Make it your habit. Do it for months. Then - and only then - the really impressive results will come.

Tip 1) Plyometric exercise. You may have heard the word. Basically it stands for making a muscle contract immediately following relaxation, and repeating it many times. Applied to jumping in a basic case, it means that you jump, go down in the knees when you land relaxing your muscles, and immediately jump up again from the crouched position. This is tiring as hell, and for a reason - it puts the maximum stress on the
large leg muscles. If you are not used to it, your legs will probably ache after a few dozen repetitions. However, nothing beats this kind of exercise if you want to improve your jump quickly.

These tips should already get you underway, but they are just the tip of the iceberg. There's a bunch of other highly effective, yet not so widely known techniques on quickly improving your vertical. Check out
http://www.howtodunk.org for a lot more effective, hands-on info on learning to dunk.