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Glucosamine Fails to Relieve Hip Arthritis StudyTuesday, February 19. 2008
Glucosamine fails to ease hip arthritis
Two-year study shows no improvement in pain or joint movement
February 19, 2008 Link MSNBC NEWS Many people take glucosamine for arthritis-like symptoms but results of a new study suggest that glucosamine has no clinically meaningful effect on pain, function, or disease progression in patients with arthritis of the hip. In a study lasting 2 years, Dr. Rianne M. Rozendaal and colleagues at the Erasmus Medical Center in Rotterdam, the Netherlands randomly assigned 222 patients to glucosamine (1500 milligrams daily) or to placebo. The patients had relatively early stages of the hip arthritis; about half of them had mild arthritis for a period of 3 years or less. The research team took care to ensure the integrity of their results. The supplier of the glucosamine was required to double-check that the tablets were the correct dose, and all physicians, patients, and researchers were blinded to group assignment. The rate of completion was high (93 percent), and the study was conducted without drug company funding. In spite of the carefully controlled trial conditions, treatment allocation (glucosamine or placebo) had no significant effect on pain scores, physical function, stiffness, use of pain medication, or progression of hip arthritis, Rozendaal's team reports in the Annals of Internal Medicine. The writers of a commentary published with the study, note that despite numerous studies, definitive evidence of glucosamine's efficacy is lacking. They attribute much of the uncertainty to non-standardized glucosamine preparations, inadequate "blinding" in studies, and differences in outcome measures. MSNBC NEWS
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Increasing Bone DensitySunday, August 5. 2007NewsTarget.com printable articleOriginally published August 6 2005Bone density sharply enhanced by weight training, even in the elderlyby Dani VeracityAs people reach old age, osteoporosis is a major determining factor in quality of life. In Healing Moves, Dr. Mitchell and Carol Krucoff write, "Age-related declines in muscle and bone mass … can lead to frailty and fracture -- the primary reason older adults wind up in nursing homes." If you don't want to spend your later years resting in a nursing home, losing your independence and draining your or your family's financial resources, you need to do something to remain independent. According to numerous studies and aging manuals, that "something" is strength training, an activity known to increase bone mass and thus decrease the possibility of osteoporosis. Postmenopausal women are especially prone to osteoporosis because they lack estrogen. Most women know this and begin to take calcium supplements to ward off the debilitating disease. Calcium supplements are important, but according to Kathy Keeton's book, Longevity, they are not enough. Not only does your body need magnesium and other nutrients to assimilate calcium into your bones, it also needs strength training to retain calcium. Keeton quotes nutritional biochemist Dr. Neil S. Orenstein: "Without consideration of these effects, no amount of calcium supplementation will prevent osteoporosis." Numerous studies demonstrate strength training's ability to increase bone mass, especially spinal bone mass. According to Keeton, a research study by Ontario's McMaster University found that a year-long strength training program increased the spinal bone mass of postmenopausal women by nine percent. Furthermore, women who do not participate in strength training actually experience a decrease in bone density. In Prescription Alternatives, Professor Earl Mindell and Virginia Hopkins detail these findings: "In a recent study on bone density and exercise, older women who did high-intensity weight training two days per week for a year were able to increase their bone density by one percent, while a control group of women who did not exercise had a bone density decrease of 1.8 to 2.5 percent. The women who exercised also had improved muscle strength and better balance, while both decreased in the non-exercising group." Increased bone density, improved muscle strength, better balance -- these three things will dramatically improve your later years and increase your longevity. Only these health improvements can help prevent a bad fall, which is often a turning point in an elderly person's life. One bad spill can result in a broken hip, an injury that can lead to an elderly person's immobility and dependence on others. Only strength training can provide these benefits, but what exactly does "strength training" or "weight training" mean?
A little training goes a long wayStrength training does not mean that you have to train for the Olympics or tediously do the same exercise over and over. According to Healing Moves, a variety of exercises will yield bone-building benefits: "Physical impact and weight-bearing exercise stimulates bone formation. Just as a muscle gets stronger and bigger the more you use it, a bone becomes stronger and denser when you regularly place demands upon it.The best bone builders are exercises that put force on the bone, such as weight-bearing activities like running and resistance exercises like strength training. In general, the greater the impact involved, the more it strengthens the bones." However, it is important to distinguish the exercises that will increase bone density from the ones that will not. "Weight lifting, including curls and bench presses, is a beneficial activity … Dancing, stair-climbing and brisk walking are all weight-bearing exercises, which promote (good) mechanical stress in the skeletal system, contributing to the placement of calcium in bones. Aerobic exercises such as biking, rowing and swimming do not strengthen the bones," writes Gary Null in Power Aging. Now, aerobic exercise is great for your cardiovascular system, so you still should do it along with strength training. You don't have to devote a lot of time to strength training to experience the benefits. Null believes that only 15 to 30 minutes of weight training, two to three times per week, can provide you with the bone density you need to prevent osteoporosis. Just make sure that you work all your different muscle groups and allow a 24-hour lapse between sessions. For best results, women should start strength training long before menopause; however, women can experience the benefits at any age. "A 1994 study published in the Journal of the American Medical Association revealed that women as old as 70 who lifted weights twice a week for a year avoided the expected loss of bone and even increased their bone density slightly," writes Robert Haas in Permanent Remissions. According to Dr. George Kessler's Bone Density Program, "One study of people in their 80s and 90s living in nursing homes who exercised with weight machines three times a week for just eight weeks showed improvements in strength, balance and walking speed." It's never too late to lift just a few light weights and increase your bone density.
The experts speak on strength training and bone density:Without resistance exercises to strengthen muscles and bones, most people face a midlife slide into flabbiness and its associated ills. And as we age, strength training becomes even more important to offset age-related declines in muscle and bone mass that can lead to frailty and fracture— the primary reason older adults wind up in nursing homes.Healing Moves by Carol Krucoff and Mitchell Krucoff MD, page 144 Osteoporosis. Bone-thinning osteoporosis can lead to fractures,
especially
hip fractures, a major medical problem for
the elderly.
One way to maintain strong, healthy bones is to get plenty of
calcium. Certain kinds of exercise, including strength training,
also help keep bones healthy. In addition, weight training helps
prevent fractures by strengthening the leg muscles, contributing to
improved balance and decreasing the likelihood of falls, the cause
of most fractures in the elderly. Because nine out of 10 hip fractures result from falls, engaging
in activities that increase strength and balance helps decrease the
risk. strength training is one of the best ways to increase bone
density in the spine naturally and prevent falls. Postmenopausal women are at the greatest risk for brittle bones Men also can have brittle bones, but women — especially thin
women who are past menopause — are at greater risk. If you're thin,
you have less weight bearing down on your bones during normal
activity, and that means your bones will weaken faster. It's
particularly important for you to start a regular program of
weight-bearing exercises such as walking, jogging, or strength
training. Studies have found gardening is also good at pumping up
your bones so if you enjoy that activity, keep it up. The fresh air
and sunshine are an added bonus. Calcium suplements are not enough Simply increasing your calcium intake doesn't guarantee that the
calcium is going to get into your bones. To properly absorb calcium
the body needs other nutrients as well—magnesium, for one, and other
vitamins. Exercise, particularly weight training, helps the bone
retain its calcium. "Without consideration of these effects," says
the nutritional biochemist Dr. Neil S. Orenstein of Lenox,
Massachusetts, "no amount of calcium supplementation will prevent
osteoporosis." Numerous studies demonstrate strength training's ability to increase bone mass, especially spinal bone mass There's even some evidence that increasing
muscle mass
can increase bone mass. When researchers at McMaster University in
Ontario put a group of postmenopausal women on a year-long program
of anaerobic strength training, not only did their muscle size
increase by 20 percent, but their spinal bone mass rose by 9
percent. It's possible, then, that strength training might help ward
off osteoporosis. In a recent study on bone density and exercise, older women who
did high-intensity weight training two days per week for a year were
able to increase their bone density by 1.0 percent, while a control
group of women who did not exercise had a bone density decrease of
1.8 to 2.5 percent. The women who exercised also had improved muscle
strength and better balance, while both decreased in the
nonexercising control group. We know that weight lifters have much denser bones in their back
and legs than do runners, for example. Studies do show that walking
prevents bone
loss in the spine, but strength training has been proved to
build bone mass in the spine and hip. One study that (deservedly)
got a lot of media attention followed a group of postmenopausal
women who were generally healthy—but sedentary. None were taking
HRT, or any other
bone-related medicines, or taking calcium supplements. Half
performed a simple weight-lifting routine twice a week, while the
other half stuck with their couch potato ways. After one year, the
weight lifters built their bone mass 1 percent on average, at both
the hip and spine. That compares favorably to what you'd see with
HRT alone. To give you perspective, consider this: the women who did
not lift weights lost up to 2.5 percent of their bone mass over the
same time period— and also lost muscle mass and gained
body fat and
weight. The weight lifters became much more active in general (as
the researchers calculated it, a 27 percent increase), while the
sedentary group became less active. The weight lifters lowered their
body fat, gained muscle, and had better balance and more strength.
And here's a wonderful bonus: the researchers had the daughters of
the women who lifted weights come in and do the tests their mothers
were acing. In every case, the weight-lifting women outperformed
their own daughters! A Journal of the
American Medical Association article reported a Tufts University
study in which forty postmenopausal women. 50 to 70 years of age,
were tested and measured by their participation in different levels
of exercise. The conclusion of this study was that high intensity
strength training exercises are an important, effective and feasible
means to preserve bone density. In other words, exercise prevented
the onset of osteoporosis. Still, we were confident that Ramona could do even better, so we
told her to work harder and to try some strength training as well.
When Ramona came back to see us one year later, her bone density was
10 percent higher. And she had become a fanatic about strength
training, working out four times a week. Strength training does not mean that you have to train for the Olympics or tediously do the same exercise over and over: A wide variety of weight-bearing exercises yields bone-building results Physical impact and weight-bearing exercise stimulates bone
formation. Just as a muscle gets stronger and bigger the more you
use it, a bone becomes stronger and denser when you regularly place
demands upon it. The best bone builders are exercises that put force
on the bone, such as weight-bearing activities like running and
resistance exercises like strength training. In general, the greater
the impact involved in an activity, the more it strengthens the
bones. That's why the bones in the racket arms of tennis players are
denser than the bones in their nondominant arms. When muscles and
gravity aren't pulling on the bone, humans can lose bone mass
rapidly. This is dramatically illustrated when people are forced by
injury or ill health to undergo complete bed rest and, as a result,
lose about 1 percent of their bone mass per week. This is similar to
the devastating effects on bone mass seen in young, healthy male
astronauts in outer space, due to the loss of gravity. Exercise for Skeletal Health. Weight-bearing exercises are very
important to help avoid osteoporosis. Weight lifting, including
curls and bench presses, is a beneficial activity. Women should not
resist going to gyms as they age. But even if you don't go to a gym,
you can still profit from taking a little one-pound weight and
curling it throughout the day. In fact, you can take a five-minute
break every hour to do exercises. Dancing, stair-climbing, and brisk
walking are all weight-bearing exercises, which promote mechanical
stress in the skeletal system, contributing to the placement of
calcium in the bones. Aerobic exercises such as biking, rowing, and
swimming do not strengthen the bones. Not only is weight training safe, it is important for preventing
osteoporosis. As muscles are pulled directly against the bone, with
gravity working against it, calcium is driven back into the bones.
It also stimulates the manufacture of new bone. This adds up to a
decrease in the effects of osteoporosis by 50—80 percent. Women need
to do weight training two to three times per week for fifteen to
thirty minutes. All the different muscle groups should be worked on.
Twenty-four hours should lapse between sessions to rest muscles. For
best results, an exercise program should be started long before the
onset of menopause. Walking may be the best all-around exercise, but as far as bone
building goes, strength training is the cream of the crop. The pull
of muscle against bone stresses a bone, and that kind of stress is
what makes a bone become stronger. Impact also strengthens a bone,
but the impact that comes from running or jumping, say, can be
otherwise harmful to the body. Muscle working against gravity
provides another kind of impact for the bones, stimulating bone
formation and slowing loss. Strength training with free weights
(including light hand and ankle weights) or weight machines is the
most direct way to provide that stress and impact of muscle on bone,
which is what makes it ideal for building and preserving bone
density. Since stronger muscles do a better job of holding joints in their
proper places, resistance training can lessen the joint wear and
tear associated with osteoarthritis, the type of
arthritis
that most often afflicts older adults. What's more, studies find,
weight training can strengthen your bones, offering added insurance
against osteoporosis. That's because your bones and muscles are
intimately connected. When you work your muscles against resistance,
they pull on the bones they're attached to. In medical lingo, your
muscles exert stress on your bones, and your bones, under stress,
respond by laying down more calcium to reinforce themselves,
explains Dr. Ades. Not only is weight training safe, it is important for preventing
osteoporosis. As muscles are pulled directly against the bone, with
gravity working against it, calcium is driven back into the bones.
It also stimulates the manufacture of new bone. This adds up to a
decrease in the effects of osteoporosis by 50 to 80 percent. People
need to do weight training two to three times per week... Do strength-building exercises, such as
weight
lifting, three times a week for at least ten minutes. This is
particularly important for women, since it helps maintain bone
density. Strength training is also one of the proven ways to reduce the
risks associated with osteoporosis, because strong muscles can
support the bones more effectively. Strength training also slows the
aging process, improves posture and balance, and increases energy,
strength, and stamina. Almost any type of vigorous exercise will maintain or build bone.
Dr. Lee recommends walking, biking, tennis, or weight lifting. The physical stresses to which bones are subjected during
exercise stimulate new bone growth. Get at least 30 minutes of
walking, weight lifting or another weight-bearing exercise, three
times a week. Exercises that put stress on your bones, such as jogging and
weight training (even light weights), will also strengthen your
bones, whereas exercises that do not stress your bones, such as
swimming, will not improve bone strength. For best results, women should start strength training long before menopause; however, women can experience the benefits at any age. Extensive research has shown that muscles and bones will get
stronger in response to strength training regardless of your age.
Some health experts call strength training "the closest we've come
to a fountain of youth." Aerobic exercise has long been touted as a way to prevent or slow
bone loss, but researchers increasingly emphasize the benefits of
strength training, such as weight lifting, to prevent bone loss at
any age. A 1994 study published in the Journal of the American
Medical Association revealed that women as old as 70 who lifted
weights twice a week for a year avoided the expected loss of bone
and even increased their bone density slightly. One study of people in their 80s and 90s living in nursing homes
who exercised with weight machines three times a week for just eight
weeks showed improvements in strength, balance, and walking speed.
Even people who are already frail can, with proper exercise using
light weights, build up enough leg strength to walk without a cane.
I've no doubt of the bone benefits that went along with these
results, even though they weren't tracked by the researchers. Strengthening exercises such as weight training are as important
as calcium for strong bones, and they can be started at any age.
Even someone age 80 or older can be helped by weight training or
isometrics—a form of exercise that involves contracting and
releasing specific muscles. Your hospital, community recreation
center, or senior center is likely to have more information on this
exercise technique. The more bone you build early in life, the better you will be
able to withstand the bone loss that starts to occur by about age
35. Years later, the loss of bone mass can result in the
debilitating disease called osteoporosis. To develop bone mass, you
need to make weight-bearing exercise part of your daily life—with
activities like walking, running, and weight lifting. Weight lifting is not just for the young. Gerontologists and
others who study aging now know that muscles built when you are 40,
50 and 60 can help more than just your self-esteem. Developed leg,
trunk and arm muscles help protect older bodies from injuries
related to frailty. These muscles help keep bones, which peak in
density between ages 21 and 30, stronger longer. As with every other strategy in this book, it is never too late
to benefit from strength training. You know you should be getting 30
minutes of weight-bearing aerobic exercise three times a week.
Strength training is a valuable addition because we know it builds
bone more directly and efficiently than any other kind of exercise
you can do.
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Dancing and Hip ReplacementsThursday, July 5. 2007
Hip Replacements
I went to college eager to dance. I knew then that my body wasn’t built to do what it was asked to do in training—I didn’t have sufficient turnout, and my hips were tight, but I pushed myself physically to rise to every challenge. Years after I left SUNY Purchase as a dance major, I danced 10 seasons with Donald Byrd/The Group. Every rehearsal and performance was thrilling, but it was like working out on a technical battleground with no medics and no relief in sight. One day I was a healthy 39-year-old dancer, the next day I was a crippled 40-year-old. It happened that quickly, and just as dramatically. I left Byrd in 1998 with minor pain in my right hip. I was frustrated by being the lone 40-year-old among a company of 20-somethings, so I thought the pain in my hip was stress-related. After Byrd, I signed a year-long contract with the road company of Joseph and the Amazing Technicolor Dreamcoat. Halfway through that year, after having jumped off a three-foot platform eight shows a week, the ache that I thought was stress-related became more serious. At first the pain in my hip inhibited me from working fully. Eventually it stopped me from working altogether. I went to two doctors, who concurred: I needed to stop dancing and consider hip replacement surgery. My career of more than two decades was over. I cried for a month. I hid in my apartment, drinking heavily and watching movies on TV. Without dance, I didn’t want to live. What other skills did I have? I had never waited a table in my life (which I shamelessly boasted about during my career). I went from being the lucky dancer who was always working to someone who had no income. Since that depressing day in the doctor’s office, I’ve heard of other dancers who have had hip replacements, including Judith Jamison, Arthur Mitchell, Gelsey Kirkland, Gary Chryst, Bebe Neuwirth (see “Vital Signs,”), and, as I’ve come to realize, many of my friends... Neither the Arthritis Foundation nor the American Academy of Orthopedic Surgeons has statistics on the number of dancers with hip replacements. However, Dr. Robert Buly adds, “If a patient has a predilection to develop arthritis, it may be hastened by a prolonged dance career, which puts significant stresses on the body.” ...Orthopedic surgeon Dr. William G. Hamilton, who treats dancers from both New York City Ballet and American Ballet Theatre, says that it’s a mistake to draw conclusions about the source of hip pain. “Although arthritis of the hip seems to be more common in dancers, there is little hard data to support this. The classic story about Suzanne Farrell is a good example. When her hip went bad at the end of her career and she had to have it replaced, the press blamed it on the severity of the Balanchine technique that she had danced all of her life. She said, ‘No one bothered to ask me about it, but my father had bad hips and had to have them both replaced.’ Shortly afterwards, her other hip went bad and also had to be replaced...” ...Is arthritis of the hip a sign of the times in the dance business? No one knows the answer, but we do know that many of us have it. It may have been a painful dance, but it’s not painful anymore. I’m still dancing! Michael Blake, who has danced with Murray Louis and José Limón, teaches movement for actors at Rutgers University and HB Studio. He continues to dance with PARADIGM... READ COMPLETE ARTICLE
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Pain MedicinesThursday, June 28. 2007
Do you have questions about pain medications.
What are NSAIDS, narcotics, acetaminophen combinations? Emedicine Health.com has a great article about everything you would want to know about these medicines. What they are, how they work, possible addiction and withdrawl. READ COMPLETE ARTICLE
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Dietary Calcium Better Absorbed than SupplementsSunday, June 24. 2007For Protecting Bone Health, Dietary Calcium Better Than Supplements
Main Category: Nutrition / Diet News Article Date: 22 Jun 2007 - 5:00 PDT Women who get most of their daily calcium from food have healthier bones than women whose calcium comes mainly from supplemental tablets, say researchers at Washington University School of Medicine in St. Louis. Surprisingly, this is true even though the supplement takers have higher average calcium intake. Adequate calcium is important to prevent osteoporosis, which affects an estimated 8 million American women and 2 million American men. Another 34 million Americans have low bone mass, placing them at increased risk for osteoporosis. Calcium consumption can help maintain bone density by preventing the body from stealing the calcium it needs from the bones... "Only about 35 percent of the calcium in most supplements ends up being absorbed by the body," Armamento-Villareal says. "Calcium from the diet is generally better absorbed, and this could be another reason that women who got a high percentage of calcium in their food had higher bone densities."
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