Entries for August 2008

You couldn't tell it from her smile, but Dara Torres was dealing with some serious pain during the Olympics. She had surgery on her shoulder this week to shave down the end of her collarbone and relieve some of the pain from the degenerative arthritis she's developed in her acromioclavicular, or AC, joint. That joint is formed where the clavicle meets the top of the shoulder blade, and injuries to it aren't uncommon, especially among athletes who use overhead motions, like swimmers or tennis players, says Rebecca Demorest, a sports medicine physician at the Hospital for Special Surgery in New York. Those athletes can get arthritis from repeatedly stressing the joint, which erodes the cushioning cartilage and may cause the bones to painfully pinch the surrounding tissue. That's apparently what has happened to Torres. (Demorest isn't familiar with the details of her case.)

Serious bodybuilders who lift heavy weights over their heads are also at risk of AC joint injury, she says. In their case, the bone can actually start to die a bit at the end of the clavicle. "But the most common way to injure the joint is if you fall on the side or front of the shoulder," she says. People who get such a separated shoulder may be at some small risk of future arthritis in the joint, she says. As far as fixing any AC joint problems, physical therapy and more conservative measures such as rest and icing are always the first steps, but especially among high-level athletes like Torres, surgery to remove excess bone is sometimes required.

I've written previously about how gyms and personal trainers are increasingly targeting the older crowd, teaching them how to exercise safely in light of whatever medical issues they might have. I found one trainer with multiple credentials in training this population, including a senior personal training credential from the American Senior Fitness Association and the American College of Sports Medicine's cancer exercise specialist certification. At the age of 65, Jerry Hart has spent 20 years in the fitness industry and is still training clients part time in Bethesda, Md. We talked about what he does differently with older folks.

What are your clients' goals?
In the club where I work now, the goals are all over the map. Typically people want to lose a little bit of weight—you're un-American if you don't! But for my older clientele, a lot of it comes down to maintaining independence. They don't want to fall. They don't want to be fearful about falling. They want to be able to do the things they had to stop doing. It's really a kick in the anatomy when you can take a client like that and enable them to get their confidence back. At this point I don't want to work with someone who is trying to lose those last 10 pounds; I want to work with someone who has a real need. And I can identify with them—I want to be active, too.

When I wrote about the myths and truths about running, I got a lot of blowback over the notion that running won't ruin your bones and joints. It turns out that plenty of people blame running for just that, so I decided to investigate the idea further. I talked to two orthopedic surgeons who happen to practice in the same neck of the woods. For fun, I found one nonrunner (Michael Klassen, of Monterey Peninsula Orthopedic & Sports Medicine Institute in Monterey, Calif., who'd rather ski or golf) and one who does run, for fitness (Peter Gerbino, of Monterey Joint Replacement and Sports Medicine). Here's what they had to say:

A recently published study found runners don't get osteoarthritis any more often than nonrunners. True?
More or less, Gerbino thinks. "All of the well-done studies show that, for someone who is healthy, has normal joints, no underlying injuries or disease—and isn't bowlegged—running will not cause osteoarthritis." (Even if you're a marathoner.) The catch, he says, is that if you have ever had a knee injury—say a tear to the meniscus or a ruptured anterior cruciate ligament (ACL)—you are at higher risk of arthritis in that knee. That risk exists whether or not you run, Gerbino says, but running may wear out the cartilage and bring on osteoarthritis faster.

Amid the excitement of the Olympics, it's easy to forget how many athletes trained to compete in Beijing but couldn't because of injury. Soccer star Abby Wambach broke her leg, for example, and two members of the women's gymnastics team are competing in only one event because of ankle problems. And we'll neverknow the names behind the thousands of careers that were derailed by injury before even coming close to competing on the international stage. Author and journalist Michael Sokolove sees a particular problem in the women's sports arena, which he says faces an "epidemic" of injuries. (Here's a list of common sports injuries in women.) In his recent book Warrior Girls, he explores the tension between telling our daughters that they can do anything the boys can do and recognizing the reality that girls may be particularly susceptible to crippling injuries.

You talk to a lot of young women with multiple ruptures of the anterior cruciate ligament (ACL). Is it really more prevalent in women?
There's a lot of research on this, and it's ongoing. But the way it's usually said is that in the sports that girls and boys play in common and by the same rules—including soccer and basketball—girls are considered 5 to 8 times more likely to suffer an ACL injury. Just two times the rate of incidence would be significant!

Whew! I spent so much time sorting through the comments on yesterday's post about the three myths (and one truth!) about running that I missed my own scheduled evening run. Some of the people who responded had questions about how to start or maintain a new running routine. For the basics, I consulted the expert: John "the Penguin" Bingham, who writes a column for Runner's World magazine that is aimed at middle- and back-of-the-pack runners. (He also answers questions in his blog.)

How do you start running? Just, er, start running?
I recommend you begin by walking consistently for a couple of weeks, just to get moving and make regular activity a habit. Then integrate a little bit of running—and I mean a little bit, like 30 to 45 seconds of running every four or five minutes of walking. Gradually, over time, change that. Some people may find they like to do mostly walking with some running, others will end up mostly running and still do some walking, and others will really like running and do that exclusively. But it will take longer than you think [to work up to running]. The people who try to run a 5k after three weeks of running are the ones who get hurt.

Every person who takes up running has, at one time or another, been confronted by a helpful critic who is more than happy to reel off the reasons running will ruin your life. It will cripple you in your later years; you might drop dead in the middle of a marathon; and on and on. As an avid runner, I have a lot riding on whether or not these ideas about the sport are true. Here is a look at four questionable claims about running and health, including results from a new study looking at running, longevity, and disability.

1. Running will give you a heart attack or other heart problems. It is true that exercise temporarily raises the odds of a heart attack while you're mid-workout, but doing it consistently reduces that risk over the long haul, leading to a net benefit. Some researchers have questioned whether marathon running, especially in people who haven't trained a lot, might cause heart damage, at least temporarily. But there's no evidence that it causes long-term harm or actually leads to heart attacks. Even athletes with enlarged hearts—if they're healthy hearts—aren't, as once feared, at risk of early death. The bottom line: Simply going for a run most days of the week is doing far more good than bad for your heart.

Last summer, I was making my way through the final miles of the marathon leg of Ironman Canada and was not at all pleased with my performance. I knew, if I just ran a little faster, I could finish in under 13 hours, but I couldn't seem to muster up the will to do so. Then I passed a water stop where the volunteers had set up a boom box. An old favorite from the '80s, Juice Newton's "Queen of Hearts," started blasting from the speakers, something clicked in my mind and legs, and I was able to pick up the pace.

Music is powerful. That's why you'll see Olympic athletes spending their last prerace minutes with iPod headphones stuck in their ears. It's why your spinning class seems to fly by if you like the instructor's all-Madonna soundtrack—and seems interminable if you don't. René Murphy, an associate professor at the School of Recreation Management and Kinesiology at Acadia University in Nova Scotia, got interested in the topic of music and performance when one of the cross-country runners he coached missed a tough group interval workout and made up the same workout herself while listening to music. "She said, 'When I do it with everyone, I'm exhausted and it hurts, but when I do it myself, it's easy,'" says Murphy.