People are always looking for new ways to push their workout to the next level. Everybody wants to go faster, jump higher or run farther, but some techniques are better than others when it comes to improving your performance. While ankle weights can be beneficial during some workouts, they can do more harm than good if you wear them during long runs. Below, we’ll discuss some of the risks associated with wearing ankle weights during a run.
Improper muscle development – Proponents of ankle weights argue that they encourage muscle development in your legs and feet. While this may be true, overdeveloping some muscles while neglecting others can put you at risk for an injury. Because ankle weights make you to exert more force lifting your foot, you’ll be strengthening your quad muscles, but your hamstrings in the back of your leg will not be getting such an intense workout. Over time, your quad can become disproportionately stronger than your hamstrings, leaving you susceptible to injury.
Imbalance – Similar to when you step off a moving sidewalk in an airport, once you are subjected to a change in your walking pattern you can become imbalanced. If you wear ankle weight during a run, your body will begin to compensate for the extra weight. Once you remove the weights, there will be a natural adjustment period that can put you in danger. If you’re walking up or down stairs, you might step farther than intended because your brain is still compensating for the weight you just removed. You could hurt yourself with just one misstep.
Lower-body injuries – As we noted above, ankle weights force an individual to exert more effort in order to move their legs. The extra weight puts additional stress on your knees, joints and ligaments, which can lead to tears or tendonitis, especially if you have an improper running form. If you ignore a small problem caused by ankle weights, it could lead to an even bigger problem down the road.
Other areas affected – You might think ankle weights only target the muscles in your legs, but they also force you to use your back muscles. With each step you take, your body acts as a natural “stress absorber”. By wearing ankle weights, you force your back muscles to absorb more stress. This can lead to chronic pain in your lower back region.
What you should do instead
There are several ways improve your performance without harming your body. One way to challenge your muscle groups is by running on hilly terrain. We’ve cautioned against running on uneven ground, but it you can find a paved trail that takes you up and down some hills, you’ll soon notice a positive change in your muscle development and endurance.
If you’re dead set on using ankle weights, use them during other activities instead of on a run. Ankle weights are best used in resistance training, and you can consult with a personal trainer or a foot specialist on which exercises you can safely use the weights. Another popular spot to use ankle weights is in your local pool. The natural resistance of the water will help offset some of the strain put on your joints and back.
Related source: Fitness Republic
Two separate studies further emphasized the importance of exercise in older individuals, as regular workouts were linked to better heart health and a decreased likelihood of developing cancer.
Keeping Your Ticker Happy
A study by researchers at the University of Texas Southwestern Medical Center found that individuals that increased their fitness levels over an 8-year period, as well as those who continued to stay fit, reported lower rates of hospitalization for heart failure than those who had low levels of fitness.
“The risk of heart failure in your 60s and 70s is modifiable through sustained exercise beginning in midlife,” Dr. Ambarish Pandey said in an interview with MedPage Today. ”We have known for a few decades that a change in fitness is associated with a reduced risk of mortality. But no one had looked at the impact of improved fitness over time on the risk of heart failure.”
For their study, researchers ranked the fitness levels of over 9,000 participants. Each individual was assigned a fitness level, 1 being the lowest level and 5 being the highest level of fitness. The average age of a participant was 48 years old.
Researchers conducted an initial cardiorespiratory fitness test at the beginning of the study, and they ran a similar test about 8 years later. After analyzing the results, researcher found:
- Participants who had a high level of fitness and maintained that level had a heart hospitalization rate of about 0.30%
- Participants who had low fitness but increased their fitness to a high level experienced a heart hospitalization rate of about 0.65%
- Those who went from high to low fitness had a rate of about 0.75%
- Those who had a low level and stayed at that level had a heart hospitalization rate of 0.83%
Pandey said the results confirmed the importance of exercise as we age.
“It’s important to realize that the benefit of reduced heart failure hospitalization comes from sustained exercise over time.”
Fitness Lowers Cancer Risk
Researchers at the Cooper Clinic in Dallas found that physical fitness in middle-aged men can reduce the risk of lung and colorectal cancer, and exercise can decrease the mortality rates for men who develop these cancers.
For their study, researchers examined 17,049 men to determine their fitness level and lung capacity. The average age of a participant was 50 years old. The study then looked at clinical data 20 years later to determine how many patients had developed prostate, colorectal or lung cancer, the most common cancers among U.S. men.
Researchers found that 2,332 individuals were diagnosed with prostate cancer, 276 with colorectal cancer, and 277 with lung cancer. Over the time period, cancer was the cause of death in 347 patients.
After comparing the data to the previous fitness tests, researchers found that men in the highest quintile of fitness were significantly less likely to develop lung or colorectal cancer, although their was no difference in prostate cancer rates.
Dr. Susan Lakoswi, a researcher in the study, said the findings might impact how doctors prescribe exercise routines for patients.
“Physical activity and fitness are very different,” said Lakoski.
She also cautioned that simply because a person is not obese, doesn’t mean they are physically fit.
“Even if men are not obese, they still have an increased risk of cancer if they aren’t fit,” she said.
Dr. Silverman comments
These studies really highlight the importance of exercise and physical fitness as we age. Workout out is really healthy for you, as it reduces your risk of heart disease and cancer development.
Now that winter is gone, I urge people to get outside and stay active. Summer is here, which gives you less of an excuse to skip your workout.
It’s time we as a nation put down the remote and went outside.
Related source: MedPage Today
There are thousands of ways a person can fracture their foot, and most of them stem from a prolonged or direct impact to the foot region. Below, we’ll examine the signs, symptoms and diagnosis of foot fractures.
Did I just fracture my foot?
Whether you got tackled in football, fell off a ladder, or simply dropped something heavy on your foot, you know how painful a foot fracture can be. Some common ways people fracture their foot includes:
- Direct impact during sports, like fouling a ball off your foot in baseball
- Dropping a weight or heavy object on their foot
- Incorrect running form over a long period of time. Many novice and moderate runners can experience stress fractures due to poor form
- Falls from great heights. Many people suffer foot fractures as a result of falling down stairs.
Symptoms of Foot Fractures
Because your foot is made of many tiny bones, some people will experience different symptoms based on what bone is broken. With that said, some common symptoms of foot fractures include:
- Pain or numbness in the first 24-48 hours after the injury
- Swelling
- Bruising or discoloration
- Discomfort or inability to bear weight
If you’re diagnosed with a foot fracture
If you’re diagnosed with a foot fracture, you may be able to avoid surgery if you take steps to help the bones heal. Treatment of foot fractures is similar to the treatment protocol for heel bruises. Oftentimes foot fractures will heal if you practice the RICE method, which stands for Rest, Ice, Compression and Elevation. The problem for most people is that they are unable to adequately rest their foot, and sometimes compensating for the injury can lead to complications or related issues. Try to stay off the foot as best as possible, especially in the immediate hours after the injury.
Once you’re off your feet, make sure you ice the area for at least 10 minutes. You’ll want to ice at least 3-5 times a day, so consider bringing an ice pack along with you if you have to leave your house.
Compress the foot with a bandage or towel, but do not cut off circulation. Once your foot is wrapped, try to keep your leg elevated. Keeping your leg elevated will help decrease swelling in your foot, which can help expedite the healing process.
In a companion post in the future, we’ll explore the surgical treatment options and recovery protocols associated with foot fractures.
A study published in the April 2013 issue of Foot & Ankle International found that male athletes were the group most likely to tear their Achilles tendon.
While Kobe Bryant might have the most famous Achilles tendon in recent memory, the study examined 406 Achilles injuries over a ten-year period from 2000-2010. Dr. Steven Raikin, Dr. David Garras, and Dr. Phillip Krapchev analyzed the injuries and demographics of their patients in order to produce the following findings.
- The average age of a patient with an Achilles tear was 46 years old.
- 83% of the patients were males.
- 68% of the ruptures were sports related.
- Basketball was the most common sport for injury (32%), followed by tennis (9%), and football (8%).
- Of the patients younger than 55 years old, 77% of the injuries were sports related, compared to 42% for patients 55 or older.
- Older patients whose body-mass index was above 30 were more likely to have a non-sports injury.
- Over 33% of the Achilles injuries not caused by sports occurred at work.
Researchers also found that if the Achilles injury was improperly diagnosed, it was most often classified as an ankle sprain.
Dr. Raikin said patients in their 40’s and 50’s need to be cautious when participating in sporting activities. He also recommended they seek out a specialist if they believe they might have an Achilles injury.
“Older individuals, and those with a higher BMI, should be evaluated carefully if they have lower leg pain or swelling in the Achilles tendon region,” said Raikin.
Another important finding in the study related to the percentage of re-rupture after the initial injury. Researchers found that 5% of the group suffered a re-rupture of the same tendon. While that may not seem significant, it was reported that 85% of those individuals had neglected to under surgery to address their Achilles after the first injury.
Dr. Silverman comments
As I mentioned in the Kobe Bryant piece, over a period of time your Achilles tendons undergo what is known as “silent degeneration”. Over the course of your life, normal tendon fibers slowly and painlessly tear. It can be more aggressive in athletes, especially basketball players who rely on quick turns, twists and cuts. It is not surprising that basketball was the leading sport for Achilles injuries.
What is interesting is the fact that 85% of individuals who suffered a re-rupture did not undergo a surgical operation after the initial injury. When it comes to a tendon like your Achilles, you are almost always better off having a specialist repair it surgically. You may think you’re saving money by neglecting to undergo an operation, but it could be more costly, and more painful, if you have to relive the injury a second time. Improper healing of the Achilles tendon leads to weakness in push off and abnormal gait.
Related source: News-Medical.net
Steph Curry helped the Golden State Warriors even their series with the San Antonio Spurs on Sunday, once again fighting though ankle pain stemming from a sprain he suffered in Game 3.
While the series stands deadlocked at 2-2, it appears that Curry’s greatest opponent this series may be his own ankles. Curry sprained his ankle near the end of the regular season, and he aggravated the injury in Golden State’s first round series against the Denver Nuggets. Despite the setbacks, Curry is committed to helping the Warriors reach the Westerns Conference Finals.
“I doubt it will be 100 percent for the foreseeable future,” Curry said. ”But knowing that I can be on the court as a threat, I’ve got to be ready.”
Curry wasn’t sure is he was going to be able to place in Sunday’s contest, and he needed an anti-inflammatory shot to help ease the pain and selling. His status was still up in the air 45 minutes before tip-off, but Curry knew he needed to battle through the discomfort. He informed head coach Mark Jackson that he was going to do whatever he could to help his team win.
“He said, ‘I’m going to give you what I got, Coach,’” said Jackson. “That’s not the language he speaks. I knew right away that he was not 100 percent.”
Curry scored 22 points and grabbed six rebounds in 39 minutes to help the Warriors clip the Spurs in overtime. It seems likely that the four-year pro will undergo offseason surgery to address the issues in his left foot, but Curry isn’t ready for the season to end. He and the Warriors have Monday off before returning to San Antonio for a pivotal Game 5.
Dr. Silverman comments
How many more times do we have to see it? I am starting to feel more than pain for Curry; it’s growing into frustration.
All you need to do is watch the video. It is a perfect example of hindfoot instability. His heel plants, his ankle rolls a little and his foot rolls a huge amount. After the game, many reporters said Curry was walking without a limp, but that is common in hindfoot instability. Ankle sprains hurt and are less stable and difficult to walk on, while hindfoot sprains generally hurt less and people can compensate for them for longer.
This injury is beginning to become more problematic. He can’t pivot aggressively off of either side. He is incredibly dedicated, and he wears his heart on his sleeve every time he steps on the court, but I wonder how much more pain his ankle can take.
Heroics aside, the bilateral nature of this problem is a real issue. First, since this is an unusual condition, it is comforting to a doctor to have the other side be normal so there can be some version to compare and a goal to set. Second, hyperlaxity syndrome may be present which makes a ligament repair more complicated and more likely to fail. Finally, I would be concerned about his nerve function. Subtle nerve trouble can manifest in recurrent sprains. Sensory nerves, especially those that help prevent sprains, lose function in a number of different compression syndromes of both central (spinal) and peripheral (leg) nerves.
If I was Curry’s doctor, I would place him into an ankle brace on both legs that stabilizes the midfoot like a Trilok. While this may slow him in some circumstances, it will protect him and give him the added stability he needs to cut.
Related source: Philly.com
Diagnostic errors, be it a failure to diagnose or a wrong diagnosis, have resulted in more paid malpractice payments than any other malpractice claim over the last 15 years, a study in BMJ Quality & Safety revealed earlier this month.
Co-author of the study Dr. David Newman-Toker said diagnostic errors resulted in “the most frequent, most severe, and most costly of medical mistakes” from 1986 to 2010.
“We published this paper in part because we wanted to express the magnitude of the problem,” said Newman-Toker. “There may not be a magic-bullet solution, but we’ve got to start monitoring and measuring and reporting these errors.”
According to the data:
- 28.6% of all paid malpractice claims from 1986 to 2010 were diagnostic errors.
- 27.2% were treatment errors.
- 24.2% were surgical errors.
- 6.5% were obstetrics errors.
- 5.3% were medication errors.
- 3% were anesthesia errors.
In addition, diagnostic errors were more likely to result in death than any other kinds of mistakes.
The most common diagnostic error was failure to diagnose (54.2%), followed by delay in diagnosis (19.9%), and wrong diagnosis (9.9%). 16% of cases were unclassified.
Diagnostic Errors Difficult to Prevent
The reason diagnostic errors are the leading cause of malpractice claims is because they are often very hard to prevent. If a doctor suspects a patient has one virus, but in fact they are suffering from something else, this can cause a delay in getting the correct treatment.
“If you give someone the wrong diagnosis, it may be days or weeks or months or years before they get the right diagnosis,” Newman-Toker said.
Newman-Toker also said diagnostic errors are problematic because they can’t be prevented by other safety measures. While wrong-site amputation accidents have severely decreased with new double-checking protocols, no such system can prevent diagnostic errors.
“Diagnosis isn’t simple,” Dr. Newman-Toker said. “You’re alone with a patient in a room, asking questions. There are 100 different possibilities. You face uncertainty and time pressures. You may lack scientific knowledge. You could be looking at an early (and less defined) stage of disease.”
Newman-Toker said that perfection may be unattainable, but with better testing procedures and expanded medical knowledge, we should be able to lower the rate of diagnostic errors.
Dr. Silverman comments
A line in my training rings in my head: “You can teach a monkey to operate, you just can’t teach them when.”
Diagnostic errors plague all doctors including Orthopedic Surgeons. One of my mentors once asked me, “What kind of doctor do I want to be? Do you want to be right 85% of the time, or more often?” At the time, it was a nonsensical question as I strove for A’s all the time. Who would ever be satisfied with being right 85% of the time? That would mean that 15% of the patients would get incorrect diagnoses and incorrect treatment.
Over the years, I have learned why this was even a question. An 85-percenter will apply the most common diagnose to the complaints and physical examination of the patient. They will be correct very often (more than 4 out of 5 times). They will be fast at coming to the diagnosis and they will appear to be very knowledgeable because of their speed. Patients who are well served will adore these doctors as they seem to work miracles and don’t make them wait in the office. Lots of their friends will be similarly happy. These doctors can actually see more patients and make more money in the same amount of time. They will make a lot of people very happy, but they will do harm to those who aren’t suffering from the most common disorder.
Well, I never did anything the easy way and I wasn’t about to start then or now.
I have never stopped striving to beat the 85%. In fact, anything less than perfection bothers me to my core. My patients know this. I can’t predict what complexity of patient will walk (or often enough hobble) in my door. I consider my practice one of tertiary care. I am a sub-specialist in Orthopaedic Surgery. I manage the most complex foot and ankle problems. I never turn down anyone no matter how complex the problem. I routinely see patients who have undergone surgery from other doctors, and I am often asked to provide my legal opinion regarding such cases.
Being this open means that some days I will have only easy operations, but other days a structure that resembles a foot or ankle will roll in attached to a patient in a wheelchair with a prayer hoping I can make them better.
Patients will sit in my waiting room sometimes for 1.5 hours wondering what the heck could be taking me so long. But, after the visit, they know why. I give every patient all the time they need. That includes all the time I need to make the diagnosis and formulate the best series of options, and all the time the patient needs to ask questions and understand how I made the diagnosis. You might think I would get faster as I get older and wiser, but I don’t. While I get smarter (in doctor terms that means faster at pattern recognition of rarer more complex patterns); the patients don’t get smarter. They all need the same amount of teaching time. And as I spend more time in the practice, more people refer me to complicated patients.
Will I be wrong sometimes? Of course, every doctor makes incorrect, incomplete and delayed diagnoses, but I know they are incredibly infrequent. This paper points out why just looking at the obvious mistakes, the never-events, is only scratching the surface. We need to constantly strive to do better, be smarter and be right more often.
Related source: Medscape
Kevin Garnett may undergo an operation to remove bone spurs in his ankle before deciding if he’ll return for a 19th season in the NBA.
Now that the Celtics have been knocked out of the playoffs, the 18-year veteran will need to make two big decisions; if he’ll undergo ankle surgery, and if he’ll decide to continue his career.
The choices depend greatly on one another. Garnett would be more likely to undergo the surgery if he wanted to come back for another season, while he may opt to forgo the surgery and save further rehab on a body that has suffered plenty of wear and tear over the years.
Another factor in whether Garnett decides to come back is what the Celtics decide to do with veteran Paul Pierce. Pierce has already stated that he’d like to return for another season, but the Celtics would owe him $15.3 million if he’s still on the roster by July 1. The team has the option to buy Pierce out of his contract for $5 million, but that would leave Garnett as the sole member of the “Big Three”, which brought the team its first NBA Championship in 22 years when they won it all in 2008.
Fixing the bone spurs in Garnett’s ankle isn’t viewed as a major procedure, but with all the miles he’s put on his feet, Garnett may take longer to recover from the operation. The sooner he undergoes the surgery, the more likely it is that he plans to come back. Head coach Doc Rivers said even he doesn’t know what Garnett plans to do.
“I have no clue,” Rivers said. “I was positive last year [he was coming back]. I’m not as sure this year.”
Garnett has a two year remaining on a three-year deal he signed before last season. The Celtics were able to push the second-seeded New York Knicks to six games in the Eastern Conference Quarterfinals despite losing 4-time All-Star Rajon Rondo to an ACL injury earlier in the year. If Garnett and crew can get healthy during the offseason, they may be able to go deeper into the playoffs in 2014.
Dr. Silverman comments
This is a classic case of treating the symptoms, not the disease.
Removing the bone spurs will not fix Garnett, it will only patch him up for the time being.
You would think KG might ask, “Doctor, why did I get these spurs?” A response like, “playing basketball for so many years” or “you beat the ankle up” just wouldn’t fly in my book. Even an answer like “landing from that height so many times,” isn’t going to cut the mustard, as these answers are wishy-washy.
If landing from that height so many times is the problem, why aren’t all the player’s ankles in trouble? Why isn’t the other ankle in pain?
Garnett needs his ankle stabilized. While shaving the spurs down isn’t a major procedure, look at how long it has taken Steph Curry to bounce back. While he is doing amazing from the perimeter, he was out for half the season and he is a decade younger than Garnett. If Garnett had his ligaments fixed while they shave down the spurs it would add roughly 15 minutes to the surgery time and two weeks to the recovery time, but his ankle would become much more stable.
The problem may be that the doctors can’t tell his ankle is unstable. With lots of spurs and the great strength of the ankle stabilizers, it can be hard to feel if the ankle is moving around incorrectly. That’s where understanding ankle and foot problems come into play. Ankles get spurs from trauma and instability. If Garnett hasn’t sustained a fracture and has only suffered sprains, then the spurs come from instability. No matter how bad the spurs, they don’t get better consistently and permanently unless the ankle is stabilized.
Related source: ESPN
