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Knee Injuries Are Forever

Many sports injuries cause a progressive permanent osteoarthritis that will prevent a person from exercising to cause the very diseases that a regular exercise program is supposed to prevent. Sports medicine surgeon James Garrick, writing in the medical journal Lancet (December 2005), explains why. You are supposed to exercise. It makes you stronger, faster, healthier and may even prolong your life. However, every time you exercise, you risk injury and many sports injuries last forever. Depression, heart attacks, strokes, obesity and diabetes are all associated with a sedentary lifestyle. A twisted ankle can change an active person into a sedentary one. A torn anterior cruciate ligament or meniscus of the knee has a greater than 50 percent chance of causing permanent pain within five years, regardless of the treatment.

If you tear your anterior cruciate ligament of you knee, you must have it repaired as soon as possible. After it is repaired at surgery, you have an almost certain chance of tearing it again if you try to return to a competitive sport. When your heel hits the ground during running, your foot stops moving suddenly, forcing the upper femur bone to slide forward on the lower tibia bone at the knee. The anterior cruciate ligament prevents the femur from sliding too far forward and shearing off the cartilage in your knee. Once you tear your anterior cruciate ligament (ACL), even if it is successfully repaired, you have a weaker ACL that still lets the top femur slide forward on the tibia and shear off cartilage. So running causes you to lose cartilage until you lose it all, bone rubs against bone and you hurt 24 hours a day. The only treatment then is a knee replacement. So anyone who has broken cartilage or ACL in his or he knee should never run again for the rest of his or her life.

On the other hand, strengthening the muscles of your upper leg stabilizes the knee and helps to delay and prevent a knee replacement. Anyone with broken cartilage or a torn anterior cruciate ligament in the knee should try to pedal a bicycle every day. Pedaling is done in a smooth rotary motion without sudden stopping, so it does not cause sudden forward movement of the femur on the tibia and does not shear off additional cartilage from the knee joint. If you pedal against increasing resistance you will strengthen the muscles around the knees and increase their stability so there is less wear on the cartilage.

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Dear Dr. Mirkin: I don’t think I eat more than I did when I was younger; why do I keep gaining weight every year?

Most people become fatter with aging because they are less active, not because they eat more. Thirty minutes of exercise a day may be enough for heart fitness, but it is not usually enough to lose or maintain weight. Our grandparents doing heavy manual labor were active for 8, 10 or more hours every day. If you have a sedentary job, you need an exercise strategy that includes very vigorous exercise, more time spent in physical activity, or (preferably) both. Researchers from the University of South Carolina showed that the increase in body fat that accompanies aging can be completely prevented with prolonged vigorous exercise (Medicine & Science in Sports & Exercise, August 2005.) The authors studied 60 thousand male runners and found that the more miles they ran, the thinner they remained. Waist circumference increased with age at all running distances, but the increase diminished in the men who ran further.

This tells us that you must increase your physical activity with age to prevent weight gain. Your chances for success will improve if you find an activity you enjoy enough to do it for several hours at a time, such as dancing, fast walking, rowing or cycling. Then make your sport a regular part of your social life, not just an exercise chore.

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Dear Dr. Mirkin: Are beta blockers the best drugs for lowering blood pressure?

Beta blockers are among the most-prescribed drugs to treat high blood pressure, but a study from Sweden shows that they can increase risk for strokes (Lancet, October 29, 2005.) Brand names of the beta blockers include Toprol, Inderal, Blocadron, Coreg, Inopran, Levatol, Pindolol, Sectral, Tenormin, Timolol Trandate, Zebeta and Bisoprol. Studies show that they are the drugs of choice to treat people who have had heart attacks, heart pain, heart failure, rapid heart beat and atrial fibrillation. However, even though many physicians prescribe beta blockers to treat high blood pressure in their patients who have not had heart attacks, no data show that they prevent heart attacks in healthy people. This is the second major study to show that beta blockers do not prevent first heart attacks and may even increase a person’s risk for stroke. Besides, they often make a person so tired that he has difficulty exercising.

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Two new soup recipes for chilly days:
Minestrone
Double Mushroom Soup

List of Diana's Healthful Recipes

June 26th, 2013
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About the Author: Gabe Mirkin, MD

Sports medicine doctor, fitness guru and long-time radio host Gabe Mirkin, M.D., brings you news and tips for your healthful lifestyle. A practicing physician for more than 50 years and a radio talk show host for 25 years, Dr. Mirkin is a graduate of Harvard University and Baylor University College of Medicine. He is board-certified in four specialties: Sports Medicine, Allergy and Immunology, Pediatrics and Pediatric Immunology. The Dr. Mirkin Show, his call-in show on fitness and health, was syndicated in more than 120 cities. Read More
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