Health issues in Mid-life

Comment by 秉浩 on May 17, 2008 at 4:12pm

I will start this group with some thoughts shared recently with friends, on the subject of knee problems. A topic familiar to you? I am certain. The fact is most of us in mid-life have a knee problem. If your doctor cares to (not that he / she should) order x-rays for your knees, I'll bet you 3 to 1 that osteoarthritis will be found at your age.

So what should you do if you have a knee problem? Naturally, the first thing would be to consult your personal doctor, hopefully an internist. They are the smartest, if not the most aggressive, doctors by the nature of their specialty. Now I know I'll be inviting protests by glorifying internists at the expense of other specialties, but my real point is that you should already have a well established relationship with a smart doctor whom you can trust, if you consider yourself in the mid-life group.

Depending on the nature of your knee problem, chances are your doctor will tell you to stop exercise for a few days to a few weeks. Usually this makes good sense. The only problem is that those of us who really want to stay fit -- practically all of us who enjoy eating but abhor looking at the scale by the bathtub -- cannot just "stop exercising entirely for 6 weeks", as your doctor had ordered, without either starving ourselves or putting on another 10 pounds!

So how do you get out of this predicament? Again, talk to your doctor (i.e. that smart internist you trust) and offer him / her this (smarter) idea: how about hydro-therapy?

Forget the fancy term. Trust me, it is no more than another way of saying "exercise in a swimming pool". The idea is simply this: you take advantage of the physics of water (as opposed to chemistry or biology, for those of you scientific-minded). You see, water provides buoyancy, another fancy term for "floating". So you can exercise without putting more wear and tear on the knee. Water is also conductive, also a fancy term for absorbing heat. Hence it cools down the heat generated by your body and the knee joint much faster than air can. Water is also incompressible. This means that it is actually a good way to massage the supporting organs around your knee. Good massage, as you know, provides for good circulation and good relaxation.

So the bottom line is you feel relieved, relaxed, and probably less problematic after hydro-therapy. If you keep it up for a few weeks, I suspect you will lose, or at least stop putting on, body weight too. Now ain't that a deal?

I do realize pools have potential hazards too. It is slippery and you might fall. Getting in and out may cause more injury too especially if you are paying more attention to those wonderful body figures around you than you pay attention to your own exercises. Naturally, open wounds should not be exposed to water in the pool, because nasty germs can survive and bad skin and infections from pool and spa exposures have been reported. As always, you should get your smart doctor involved in the decision.

Still unconvinced about hydro-therapy? I have cut and paste an excerpt hot off the press if you want to take a look. It is somewhat technical but I bet you can't miss the message. I'll be happy to discuss this further in the future if anyone is interested.

Hydrotherapy versus conventional land-based exercise for the management of patients with osteoarthritis of the knee: a randomized clinical trial.

Information from Industry


Phys Ther. 2008; 88(1):12-21 (ISSN: 0031-9023)
Silva LE; Valim V; Pessanha AP; Oliveira LM; Myamoto S; Jones A; Natour J
Rheumatology Rehabilitation Section, Division of Rheumatology, Federal University of São Paulo, São Paulo, Brazil.

BACKGROUND AND PURPOSE: This study was designed to evaluate the effectiveness of hydrotherapy in subjects with osteoarthritis (OA) of the knee compared with subjects with OA of the knee who performed land-based exercises. SUBJECTS AND METHODS: Sixty-four subjects with OA of the knee were randomly assigned to 1 of 2 groups that performed exercises for 18 weeks: a water-based exercise group and a land-based exercise group. The outcome measures included a visual analog scale (VAS) for pain in the previous week, the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), pain during gait assessed by a VAS at rest and immediately following a 50-foot (15.24-m) walk test (50FWT), walking time measured at fast and comfortable paces during the 50FWT, and the Lequesne Index. Measurements were recorded by a blinded investigator at baseline and at 9 and 18 weeks after initiating the intervention. RESULTS: The 2 groups were homogenous regarding all parameters at baseline. Reductions in pain and improvements in WOMAC and Lequesne index scores were similar between groups. Pain before and after the 50FWT decreased significantly over time in both groups. However, the water-based exercise group experienced a significantly greater decrease in pain than the land-based exercise group before and after the 50FWT at the week-18 follow-up. DISCUSSION AND CONCLUSION: Both water-based and land-based exercises reduced knee pain and increased knee function in participants with OA of the knee. Hydrotherapy was superior to land-based exercise in relieving pain before and after walking during the last follow-up. Water-based exercises are a suitable and effective alternative for the management of OA of the knee.

Comment by Anita on May 19, 2008 at 10:05am

I can share updates of the recovery/deterioration of my own knee problems.

Comment by 秉浩 on May 26, 2008 at 8:48am

I am now going to test-drive with a second comment, this being in the beta-phase before launch.

We had a recent get together among friends, and conversation naturally drifted to the most favored topic.... staying healthy in midlife. Surpirse?

One of the ways to stay healthy is the right diet and right exercise. Simple enough? Not really, because not everyone would agree what the right diet is, even though there seem to be better consensus that walking is a good exercise. So I think I will remember to comment a bit more about that on this comment wall.

What was I saying? Oh, that's right, remember to do it..... memory. Memory is a natural concern at midlife. Some of us have seen parent(s) fading what used to be their incredible memories -- my Mom, for example, would always remember the few times that I forgot to send LaiSee to an elderly Aunt on her birthday, and hence be my reminder to be the good nephew one week ahead. Somehow, now we find our own memory to be fading. So why is that and what can we do? While I don't have answers to these questions 80% of the time, it will still be an interesting subject to tell you stories about the other 20% of the time.... in the future.

....that is, if I remember to do so :)

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