Fitness Culture fuels Orthopedic Medicine for Boomer Generation

Over 40 years, Bob Niebuhr learned that handball doesn’t have to be a young man’s game — that an old man can deliciously keep a young man running around the court by swatting the ball with the proper power, precision and geo­metry. So when Niebuhr, 68, saw the doctor last week for a checkup after his second hip replacement, he had one burning question:

“How about handball?”

Niebuhr’s passion helps explain the explosive growth of Twin Cities clinics specializing in orthopedics and sports medicine. Minnesota has seen some $66 million in capital projects related to orthopedic care between 2008 and 2012.

And it is why the Mayo Clinic — after years of flirting with a medical presence in the Twin Cities — broke through last week with the announcement of a downtown Minneapolis sports medicine center in league with the Minnesota Timberwolves.

“The growth is being driven by a more active population, whether that happens to be in competitive sports or fitness activities,” said Dr. Michael Stuart, co-director of the Mayo Clinic Sports Medicine Center, who is in Sochi now as team doctor for USA Hockey. “I have a 65-year-old patient who plays 120 softball games a year.”

Across the Twin Cities, orthopedic clinics report booming business.

At St. Croix Orthopaedics in Stillwater, visits to urgent care more than doubled from its first year, 2012, to last year. At the TRIA orthopedic center in Bloomington, half the injury patients are athletes — many of whom line up at the walk-in clinic in football pads or jogging outfits.

“You walk over to our acute injury clinic, and you will see athletes with three or four different letter jackets on,” said Ted Wegleitner, TRIA’s chief operating officer.

The growth appears at the margins of the age spectrum, with children suffering the breaks and strains of high-level sports participation, and older adults wearing out joints after decades of running, biking or — in Niebuhr’s case — lunging after rubber balls.

“It was hard to turn my hips, and it was painful to hit the ball and follow through and to move,” said Niebuhr, who learned handball at college in La Crosse, Wis. “When you play you’re moving side to side, up and back, diagonally, you know? I would move back and really feel it.”

‘Will I be able to ski?’

Sports has always been a seductive market for business — sometimes to excess, considering reports that the Twin Cities area is oversaturated with golf courses and sports training domes.

The key question is whether Mayo’s venture will cater to an expanding market of athletes, young and old, or just intensify competition in a community where TRIA, Twin Cities Orthopedics, Summit Orthopedics, the University of Minnesota and St. Croix are among the major players.

The growing intensity of youth sports has contributed to the trend, as children specialize in their chosen sports and become prone to overuse injuries, sprains and concussions.

Stuart said there has been “quite an epidemic” of young female athletes with disruptions to their anterior cruciate ligaments, the so-called ACLs that regulate knee motion.

But it is the size and attitude of the baby boomer generation that have orthopedic center leaders confident there will be enough patients to go around. The Greatest Generation of adults, born in the first half of the 20th century, might have accepted the need to slow down, but the boomers born in the 1950s and 1960s have not, said Dr. David Fischer, an orthopedic surgeon who co-founded TRIA in 2005.




“Where our parents would have accepted a bad knee and changed their activities, this population in large part doesn’t want to do that,” he said. “They’re asking ‘Will I be able to play tennis? Will I be able to ski?’ ”

Generally, he added, their expectations are “reasonable.”
Dr. Michael Meisterling of St. Croix Orthopedics winced after his patient, Niebuhr, asked about handball after two hip replacements. But the doctor told him he could slowly return to the sport, though it might wear out his new implants.

“The new hips have a 25-year shelf life,” Niebuhr said. “In 25 years, I’ll be 94 years old. If I’m still playing handball and I need a new hip when I’m 94, I’ll go for it.”

In reality, Niebuhr plans to back off handball just a bit — there’s always golf and sledding with his two grandchildren.

The rise in obesity has also contributed to the increase in joint problems — sometimes in combination with athletics as people exercise to lose weight.

Every 15 pounds of excess weight puts 100 pounds more pressure on the body’s joints, said Melanie Sullivan, chief executive officer for St. Croix Orthopaedics.

“If you’re 45 pounds overweight, your force is 300 pounds more than what you would normally put on your joints.”

Training like a pro

Already, the clinics are competing for patients. TRIAL and Twin Cities Orthopedics duel for patients with facilities and walk-in clinics that are 2 miles apart on France Avenue. The Mayo Clinic Sports Medicine Center, which will open in 2015 across from Target Center, will include some form of walk-in clinic that will concentrate on downtown dwellers and commuters, Stuart said.

“There are a lot of people that work downtown,” he said, “and they don’t have this type of convenient opportunity to be evaluated, treated, rehabbed by any facility that is connected by skyway to … their offices.”

Aligning with high-profile sports teams can be a marketing advantage. TRIA’s Fischer has been team doctor for the Timberwolves since the team’s inception in 1989. Mayo announced it will be taking on that role.

That kind of relationship wasn’t lost on patients such as Scott Weyer, 67, of Prior Lake. While he researched the volume and quality of knee procedures at facilities as well, he was first drawn to TRIA because it treated athletes from the Twins, Wild and Vikings.

“You hear about these players that get this done to them and that done to them, and then they’re back on the field,” said Weyer, who wanted a knee procedure to stay mobile at his manufacturing job and on hiking trips with his wife. “I figured these guys must know what they are doing.”

In addition to surgery and injury treatment, clinics are creating programs to help athletes prevent injuries and physical therapy to help them recover after an operation. TRIA’s physical therapy program has grown 45 percent in three years, and it recently added equipment such as baseball netting so therapists can work with players on throwing mechanics.

Mayo will emphasize prevention and athletic performance as well, Stuart said.

“Athletes are looking to improve their strength and balance and conditioning — and how to think the game as well as reaction time and vision and nutrition,” he said. “Elite athlete are really looking for that kind of improvement, but so are a lot of competitive and recreational athletes.”

Article Source:  Olson, Jeremy. "Sports Culture Fuels Orthopedics Boom." Sports Culture Fuels Orthopedics Boom. StarTribune Media Company, LLC., 09 Feb. 2014. Web. 09 Feb. 2014.

Sisterhood is powerful incentive to use Women's Gyms

(Reuters) - Women-only gyms, once seen as the exercise alternative for out of shape women of a certain age, are actively shedding that reputation, fitness experts say.

Young, professional women are discovering that female-only fitness zones can be what a morning of golf or shooting the hoops is to their male counterparts: a chance to network, negotiate and bond while working out.

"Men have been combining fitness and a social aspect for ages, doing business and creating relationships at the same time," said Leanne Shear, trainer and founder of Uplift Studios, a boutique women-only venue in Manhattan.

"Women have not, to their detriment."

Shear said her studio, which opened in 2012, attracts professional women in their 20's, 30's and 40's, and aims to provide a social atmosphere where they can come together as a community.

As for the workouts, Shear believes that while women are certainly capable of doing everything that men do, many find the gym equipment in weight rooms bulky, off-putting and ill-suited to them.

Equipment in Shear's studio includes an elliptical machine with a smaller stride better suited to women, and instead of huge plates and bars, there are lots of dumbbells, balls, balancing equipment and body weight exercises.

A 2014 report by International Health, Racquet & Sportsclub Association (IHRSA) showed that while health club members are equally likely to be male or female, what they do when they visit the club differs considerably.

LESS INTIMIDATING

Women are more likely to gravitate to group exercise classes, Pilates, stretching, yoga, boot camps, and cardiovascular exercise machines, while men are drawn to free weights, resistance machines and sports such as racquetball and squash.

Curves International, Inc., the large chain of fitness centers for women, is known for its 30-minute circuit of cardio, strength and stretching training.

Hannah Karass, vice president of programs and science for Curves, said the circuit is in a circle for a reason.

"The members face each other, help each other," she explained.

Karass said Curves has initiated a rigorous high intensity interval training workout designed by trainer Jillian Michaels, of the TV reality show "The Biggest Loser," to attract younger women.

Karass, 50, believes women's gyms are simply less intimidating than co-ed clubs.

"I think of myself in a big co-ed gym," she said. "If I work with a 10-pound (4.5 kg) dumbbell and I see men lifting 25, there is an emotional reaction."

Dr. Barbara Bushman, of the American College of Sports Medicine, said both sexes require a balanced exercise program of aerobic activity, resistance training, and flexibility and, for older adults, balance and agility.

"To me the women-only gym fits into the enjoyment aspect," she said. "If someone feels more comfortable in that environment and that helps them to stick with their program better, it's a great thing."

She added that women tend to lag behind men in resistance training, which is important for bone health. Being properly fitted on standard machines can also be difficult for smaller women.

"At university I was only female in weight room," said Bushman, whose 5ft 10-inch height mitigated the sizing issue. "It wasn't an environment that welcomed women."

Shear sees women-only venues as a place where women are free to work their hardest without feeling self-conscious or trying to impress the opposite sex.

"The workouts are just as hard and intense as any man's," she said.

Article Source:   Internicola, Dorene. "Sisterhood Shown to Be Powerful Incentive at Women's Gyms."Reuters. Thomson Reuters, 03 Feb. 2014. Web. 06 Feb. 2014.

8 Habits that are messing with your Metabolism

A few little tweaks can help you max out your calorie burn

You exercise, and you try to eat right. But unfortunately you may still be slowing down your calorie burn—and your weight-loss efforts—without even realizing it. Lauren Slayton, M.S., R.D., author of The Little Book of Thin explains the little-known metabolism wreckers that are holding you back—and how you can burn more calories ASAP.

1. You Don't Drink Enough Water:
   "Your body needs fluids to perform all of the functions it needs to," says Slayton. And when it's not performing those functions as well, it's not burning as many calories. Something else to keep in mind: A lot of the calorie burn from drinking water comes from your body working to bring cold water to 98.6 degrees—so drinking hot water with lemon or hot tea all the time won't be as good at boosting your metabolism as cold water will.
2. You Aren't Taking Vitamin D Supplements
   "When you're low in vitamin D, you lose weight slower and your levels of the hormone ghrelin, which makes you hungry, are higher," says Slayton. Since it can be difficult to get enough vitamin D from your diet, she recommends taking a supplement from November through March—when you won't be getting as much of the nutrient from sunlight—to help you drop pounds more easily.
3. You're a Cardio Queen
   You know that exercise is crucial for keeping your metabolism fired up, but if you swear by running or indoor cycling—and only running or indoor cycling—you're not building the lean muscle that'll really give your metabolism a boost, says Slayton. Start incorporating strength training into your workouts to up your calorie burn even more.
4. You Have a Midnight Snack Habit
   There's a lot of emphasis on how important it is to eat regularly so as not to slow your metabolism down, but there's also research that suggests going several hours without eating could be better for you, metabolically speaking. "What I usually suggest for clients is a period of 12 hours without food," says Slayton. "You're hurting your metabolism if you're having a midnight snack and a breakfast before your workout at 7 a.m."
5. You Cut Caffeine Out of Your Diet
   Caffeine gets a bad rap, but it can actually give your calorie burn a slight boost, says Slayton. No one's suggesting you start pounding the stuff, but if you're already drinking green tea or coffee most days, keeping it a part of your routine could help your metabolism run at top speed. 
6. You Skimp on Sleep
   People who are sleep-deprived on a regular basis tend to weigh more than those who get a good night's rest most nights. Why? Research shows it can throw the hormones that control appetite out of whack, making you hungrier and causing you to eat more. Slayton recommends logging at least seven hours a night.
7. You're Constantly Stressed
   It's not just unpleasant to be anxiety-ridden—it's also bad for your metabolism: "Cortisol's a big stress hormone, and when that's activated, your body's more likely to be in fat-storage mode," says Slayton. On edge lately? Try one of these 40 ways to relax in five minutes or less.
8. You're Consuming Too Many Pesticides—and Eating Off of Plastic
   "If you really feel like you're doing everything right and not seeing progress, it's worth looking at where you're getting your food from and what's being sprayed on your food," says Slayton. Some of the chemicals in plastics and pesticides are endocrine disruptors called obesogens, which can set you up for weight gain.

Article Source:  Hilmantel, Robin. "8 Habits That Are Messing with Your Metabolism."Womenshealthmag.com. Rodale Inc., 03 Jan. 2014. Web. 03 Feb. 2014.

Best Diet Plan To Lose Weight

Using Your Body Type To Pick The Best Diet Plan To Lose Weight

As more and more resources are aimed at improving diets and exercise, we head toward individual plans and steps for fitness programs and diets.  We are at the point where we know that certain diets for a particular body type can result in much more dramatic weight loss as opposed to using a standard diet.  And women are embracing their individuality and looking for the best diet plan to lose weight.

To get more information or access a program designed for individuality, one should click here.

Dieting improperly or going against your body type can exacerbate an overweight body type.  Diets have been designed for particular body types as more and more information comes to light about the biochemistry of a particular body type.  Hormonal differences work to make certain women gain and store weight in different regions of their bodies.  A diet that targets a particular type of body fat is a crucial component to successful dieting.  You should choose the best diet plan to lose weight according to your individual body type.  

Women Who Spend Too Long Sitting May Die Earlier

“Why sitting for too long can be deadly for older women... even if they go to the gym,” reports the Mail Online.

The study this news is based on found an association between sedentary behavior (sitting or lying down for much of the day) and an increased risk of potentially fatal lifestyle-associated diseases such as heart disease and cancer.

This study followed a sample of almost 100,000 postmenopausal women from across the US. It assessed how long they spent being sedentary and followed them up over an average of 12 years to look at their risk of death. It took into account how physically active the women were, to see if being sedentary had an effect by itself.

The study found a general trend that women who were sedentary for longer tended to have a greater risk of death during follow-up.

The main limitation of the study is that many of the measures were collected through self-report, which increases the possibility of inaccuracies.

Still, there is an increasing body of evidence linking sedentary behaviour with increased risk of chronic diseases. Some fitness gurus have even gone so far as to say that “sitting down is the new smoking”.

While this may be a little over the top, the earlier you adopt healthy habits, the more likely they are to persist throughout your life, and the more benefit you will get from them.

Read more advice about how you can start becoming fitter and healthier through exercise and diet.

Where did the story come from?

The study was carried out by researchers from Cornell University, Ithaca, Stony Brook University School of Medicine, New York, and other US institutions. Funding was provided by the National Heart, Lung, and Blood Institute, National Institutes of Health, and US Department of Health and Human Services.

The study was published in the peer-reviewed American Journal of Prevalence Medicine.

The Mail Online’s report of the study is generally accurate, though the claim that “middle-aged women who spend too long sitting down are at greater risk of health problems – no matter how much exercise they do” is inherently illogical. If women are doing lots of exercise then they are not sitting down.

What kind of research was this?

This was a cohort study of postmenopausal women aiming to investigate the association between the time they spent in sedentary behaviour, and the risk of death overall, and from specific disease causes of cardiovascular disease and cancer.

The researchers say that few previous studies have specifically looked at older women; and also other studies have not taken into account time spent being physically active.

What did the research involve?

The study included women from the Women’s Health Initiative (WHI) Observational Study (OS) and Extension Study (ES). It assessed the women’s sedentary behaviour, physical activity, and other characteristics at the start of the study. Researchers then followed them for up to 17 years to see who died in this period, and their cause of death. The researchers then looked at whether women who were sedentary for longer were more likely to die during follow-up, even after taking into account how active they were.

A total 93,676 women aged 50 to 79 were initially recruited between 1993 and 1998 from 40 clinical centres across the US, and had data collected through interviews, questionnaires and clinical assessments. The main WHI ended in 2005, and the ES included annual mail follow-up from 2005 to 2010.

At recruitment, questionnaires asked about the total hours spent in sedentary behaviour with the questions:

• During a usual day and night, about how many hours do you spend sitting? Including time spent sitting at work, sitting eating, driving or riding in a car or bus, and sitting up watching TV or talking.
• During a usual day and night, about how many hours do you spend sleeping or lying down with your feet up? Including time spent sleeping or trying to sleep at night, resting or napping, and lying down watching TV.
• A third question asked participants to estimate the number of hours typically spent sleeping each night.

Total sedentary time was sitting time plus lying time with sleeping time subtracted. Women were divided into three categories of daily sedentary time:

• less than four hours
• four to eight hours
• eight to 11 hours
• more than 11 hours

Deaths were identified up to 2010 using hospital records, autopsy reports, death certificates, and records from the National Center for Health Statistic’s National Death Index.

They took into account various confounding factors that may influence the relationship between sedentary time and mortality, including:

• race/ethnicity
• education
• marital status
• body mass index (BMI)
• smoking and alcohol use
• history of chronic diseases (coronary heart disease, heart failure, stroke, diabetes, cancer, arthritis, hypertensive, number of falls in the past year, chronic obstructive pulmonary disease [COPD], and hip fractures before age of 55)
• hormone use
• depressed mood
• living alone
• problems performing activities of daily living
• self-reported health
• moderate to vigorous physical activity (MVPA), measured using a validated questionnaire

The analyses included all 92,234 women (average age 63.6) who had data on sedentary time available.

What were the basic results?

Average sedentary time of women in the sample was 8.5 hours a day. Generally women with higher sedentary time were:

• less likely to be of white ethnicity
• less likely to have received higher education,
• more likely to have higher BMI
• more likely to have lower physical activity levels
• more likely to smoke
• more likely to rate their health as fair or poor

During the average 12 years of follow-up, 13,316 women (14.4%) died. Overall there was a general trend for increasing sedentary time to be associated with increasing all-cause mortality, and mortality from cardiovascular disease (such as stroke and heart disease), heart disease specifically, and cancer.

Compared to women with the lowest sedentary time (less than four hours), those with the highest (more than 11 hours) had:

• a 12% increased risk of all-cause mortality (hazard ratio[HR] 1.12, 95% confidence interval [CI] 1.05 to 1.21)
• 27% increased risk of heart disease death (HR 1.27, 95% CI 1.04 to 1.55)
• 21% increased risk of cancer death (HR 1.21, 95% CI 1.07 to 1.37)

Women who were sedentary for between four and 11 hours a day were at no higher risk of death overall compared with women sedentary for less than four hours a day.

In general these women were also at no greater risk of the specific causes of death with the exception of cancer. A  21% higher risk of cancer death was found compared with those women who were sedentary for less than four hours.

How did the researchers interpret the results?

The researchers conclude that there was a relationship between greater amounts of sedentary time and mortality risk after controlling for multiple potential confounders.

Conclusion

This cohort study looking at the link between sedentary time in postmenopausal women and their risk of death, benefits from its large sample size of almost 100,000 women, and 12 year follow-up.

It finds, as previous research has found, that increased sedentary time is generally associated with increased risk of death.

The main risk was for women with the highest sedentary time (greater than 11 hours sitting per day) who were at increased risk of death from any cause and deaths from heart disease or cancer compared with women sitting for less than four hours a day.

The links were less clear for women sedentary for between four and 11 hours a day.

The study also benefits from adjusting for many confounding factors that may influence the relationship between sedentary time and mortality – including sedentary activity. The main limitation is that many of the measures taken in the study – for example sedentary time, physical activity, and medical history – were collected through self-reported mailed questionnaires.

This may reduce the reliability of some of these measures. Self-reports would not be as accurate as looking at medical records or objectively measuring activity using monitors, for example.

Though it is unclear whether self-reporting would mean that women underestimate or overestimate the time they spent sitting down during the day (but if you forced us to guess, we would go for the former).

Also, the study findings were only obtained from postmenopausal women and may not apply to men or younger groups of women.

Overall the findings support current lifestyle advice that less sedentary time and more physical activity can improve health.

 Article Source:  http://www.nhs.uk/news/2014/01January/Pages/Women-who-spend-too-long-sitting-may-die-earlier.aspx

Cardio, Strength Training May Lower Diabetes Risk For Women

Lifting weights not only improves physical fitness; it may also help lower women’s risk of type 2 diabetes, according to Counsel and Heal.

In an eight-year study, published in the journal PLOS ONE, researchers followed 99,316 middle-aged and older women who did not have diabetes at the study’s onset.

The women performed resistance exercises and lower intensity muscular conditioning exercises, such as yoga, stretching and toning.

During the study period, women who did at least 150 minutes of aerobic activity and at least 60 minutes of muscle-strengthening activities weekly had the greatest reduction of diabetes risk, compared to women who were inactive.

"The findings from our study...suggest that incorporating muscle-strengthening and conditioning activities with aerobic activity according to the current recommendation for physical activity provides substantial benefit for [diabetes] prevention in women," researchers said in a news release.

Previously, weight training had been associated with lowering diabetes risk in men. For patients with diabetes, cardio and muscle-strengthening may improve diabetic control.

Article Source:  http://www.foxnews.com/health/2014/01/15/cardio-strength-training-may-lower-diabetes-risk-for-women/

The Biggest Mistakes Women Make When Working Out

Whether it's because of the way we're built, the way we've been raised or some other reason, we tend to fall into these exercise traps. Here's what to watch out for.

• Getting Too Attached To Machines
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  The mistake: You favor weight machines over weights, and spend all of your toning time in the Nautilus room. 
  
  The issue: "Functional fitness" exercises that mimic the moves we do every day strengthen the muscles used most often and help us avoid injury. Weight machines, on the other hand, usually focus on one muscle group at a time, and they don't replicate the way we move in the course of our daily lives, says Vonda Wright, MD, a Pittsburgh-based orthopedic surgeon who specializes in injury prevention and mobility. (When's the last time you laid down on your back and pushed a heavy object up with the soles of your feet, like you would on a leg-press machine?) They're not a the most efficient way to build muscle -- for example, you'd use three different machines (leg press, back extension, overhead press) to work the same areas you would with one total-body dumbbell move (squat and overhead press), and you could still get injured. What's more, these machines are usually designed to fit men's bodies, which tend to have a longer limbs and an extended reach. 
  
  The fix: For maximum efficiency, try total-body exercises that involve squatting, bending, lunging and reaching. Wright suggests cardio-strength moves like walking lunges with a weight ball, squat jumps and wood-choppers. Or alternate your machine workouts with boot camp classes that focus on strength-building moves.
• Jumping Like A Girl
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  The mistake: When doing squat jumps or box jumps (hopping up and down with both feet on platforms of various heights), you try not to land too heavily or too hard. 
  
  The issue: When you're jumping down from any height, you increase the force and pressure on your joints, so the way you land becomes crucial in preventing injury, says Wright. Men, she says, instinctively seem to get it: They land with their butt sticking out and their knees both facing forward and deeply bent, which absorbs impact. Women, shes noticed, tend to land with their legs straighter and their knees closer together, which can be hard on the joints (it could even cause a ruptured ACL). 
  
  The fix: Wright recommends starting with standing broad jumps (where you swing your arms and jump forward with both feet) until you perfect your form and are able to land without wobbling. Increase the height very gradually, and consider stepping down to the ground instead of jumping.
• Over-Resting Between Sets
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  The mistake: You use your time in between sets to call your sister, scroll through Facebook updates or check for online sales of yoga pants. 
  
  The issue: Fitness pro Bob Greene often sees women hanging out between sets at his boot camps and the gym, which, he says, can really undermine their workouts. Socializing on the phone gives your muscles too much time to recover -- you need them slightly fatigued in order to build strength. 
  
  The fix: Instead of taking a break, Greene suggests taking a brief "pause" that lasts for just 15 to 30 seconds. "Any more than that and you'll lose the benefit you gained from the previous set," he says.
• Staring At A Concrete Wall
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  The mistake: Instead of watching yourself in the mirror, you like to zone out as you race through sets. 
  
  The issue: With the rise of the super-minimalist, industrial-chic -- or just industrial -- gyms, mirrors can be hard to find. Even in gyms where mirrors line every wall, some people find them distracting, so they don't use them. A mirror, though, can be a great way to keep an eye on your form, says Wright, and can help you make sure you're doing an exercise correctly 100 percent of the time. 
  
  The fix: Use the mirror, especially when you're doing technical moves like power cleans, deadlifts or even squats (so basic, yet so easy to do incorrectly).
• Wanting To Impress Your Trainer
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  The mistake: You don't want to admit when you're pooped or in pain. 
  
  The issue: When you're tired or unfocused, you compromise your form, and that's when injuries happen, says Jessica Matthews, an associate professor of exercise science at Miramar College in San Diego. Just one sloppy rep, especially when holding heavy weights, can cause you pain or discomfort for weeks. Over time, pushing yourself too hard -- or letting someone else push you -- can lead to serious overuse injuries.
  
  The fix: Tell your trainer as soon as you feel dizziness or pain (even soreness can be a problem if it's affecting your form) or if you're seriously dragging. You trainer won't hold it against you -- in fact, it's in his best interest to keep you healthy, safe and active.

As a reminder, always consult your doctor for medical advice and treatment before starting any program.

Article Source:   http://www.huffingtonpost.com/2014/01/14/exercise-mistakes-women_n_4561216.html