Nutrition & Physical Activity

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Eating tips when heartburn hits (Acid reflux)

Dear Reader,

Gastroesophageal Reflux Disease (commonly referred to as GERD) occurs when the contents of the stomach back up into the esophagus. Since the esophagus doesn't have the same protective lining as the stomach, these acidic substances cause irritation and discomfort. Although this has nothing to do with the heart, it is frequently called heartburn because a burning sensation is felt just behind the breastbone.

The reflux, or burning, is a symptom of a malfunction of the digestive tract — specifically, the muscle connecting the esophagus to the stomach isn't working properly. In normal digestion, this muscle, called the Lower Esophageal Sphincter, opens to allow food into the stomach, then closes. In GERD, this muscle is weak and relaxes, allowing backflow of the stomach's contents since it is not shutting properly.

In the digestive process, the stomach secretes strong acids that are needed for enzymes to do their job. Some people produce more acid than is needed, which contributes to the problems of GERD. It is often believed that spicy or citric foods cause GERD, which is not exactly true. More accurately, they often cause the acidic contents of the stomach to be more irritating to the esophagus. In any event, people who have GERD are usually recommended to stay away from these irritating foods:

  • citrus juices
  • tomato products
  • coffee
  • spicy foods
  • carbonated beverages
  • any other food that regularly causes heartburn for them (this varies from person to person)

Other strategies for people with GERD center on increasing the pressure of the Lower Esophageal Sphincter to prevent backflow of the stomach's contents, including:

  • increasing consumption of lean proteins (these help the sphincter to close)
  • decreasing dietary fat intake (fat remains in the stomach for a long time, keeping the sphincter open longer)
  • not smoking
  • avoiding peppermint and spearmint
  • staying away from both regular and decaffeinated coffee, strong tea, and chocolate

Keep the contents of the stomach small to help close the sphincter. People can eat small, frequent meals, and drink fluids between meals, rather than with meals.

It's also a good idea to avoid lying down for two to three hours after eating. When people do lie down, some find relief in elevating the head of their bed by six inches, or by sleeping on a specially designed wedge to help clear the stomach's contents from the esophagus.

Excessive use of antacids is not a good idea because they can interfere with the absorption of some vitamins and minerals. Chronic acidic irritation to the esophagus can cause permanent swallowing difficulties, so it is important to seek treatment. In rare cases, esophageal cancer can result.

If none of these strategies help, prescription medications may be needed to help reduce acid production, hasten stomach emptying, or increase the strength of the Lower Esophageal Sphincter. Your health care provider will be a valuable resource.

Alice

Will sex-ercise shed those extra pounds?

Dear Curious,

Burn, baby burn — talk about a great workout! While you may experience some of the same physical effects during sex as you would during a vigorous workout (sweating, rapid heartbeat), you may not want to rely on sex as a main source of exercise.

It is estimated that the average 175-pound person burns 150 to 200 calories during 30 to 40 minutes of sex. Of course this will vary, depending on a person's weight, the type of sexual activities involved, and a person's overall fitness level. When compared with activities such as running, cycling, or rollerblading, however, sex does not burn as many calories. A research article on sex and the heart suggests that the maximum energy expenditure during sex occurs during orgasm but returns to normal within two to three minutes after. So, while you may burn more calories during orgasm, this higher rate of metabolism is not sustained after orgasm has ended.

Keep in mind that the number of calories burned during sex depends on a variety of factors, including duration, intensity, length of orgasm, type of sexual activity (i.e., oral, vaginal, anal), and position. Individual factors such as age, weight, and body composition also influence how many calories are burned during sex as with any other physical activity. It may be helpful to check out What exactly does moderate intensity mean? in the Go Ask Alice! fitness and nutrition archives for more information on energy expenditure and how it is calculated.

If you are interested in finding ways to burn calories and/or achieve a higher level of fitness, you may want to consider starting/maintaining a regular exercise program. If you are a student at Columbia, you can check out the offerings at the Dodge Fitness Center and/or join the  CU Move initiative.  CU Move encourages members of the Columbia community to engage in active lives that include regular physical activity. The program provides participants with motivation and incentives to be active throughout the year. You can also check out the Centers for Disease Control and Prevention for more information on physical activity and calorie-burning.

So, while sex-ercise may not be the primary option for shedding pounds, you can still enjoy sex for the other benefits it provides.

Alice

To supplement or not to supplement my diet

Dear Supplementally Confused,

It may depend on the type of dietary supplement. Supplements range from daily multi-vitamins and minerals to anabolic steroids. Certain supplements are recommended for various conditions. For example, calcium supplements are often encouraged to help prevent osteoporosis, and iron is recommended for those who are anemic. Pregnant women's increased nutritional needs may require that they supplement with vitamins and minerals. The performance enhancing supplements that are so widely advertised today (i.e., creatine, chromium picolinate, protein shakes, amino acids) are not needed by the average person.

The best way to get all of the nutrients your body needs is to eat a healthy diet. To do this, you should eat a variety of foods, have a good balance within the food groups (read Food Guidelines — How much is a serving?  for details), eat enough calories (at least 1200), and make nutrient-dense choices, such as whole wheat bread and skim milk as opposed to white bread and whole milk.

Although vitamin and mineral supplements serve an important purpose for some people, you cannot depend on pills alone to provide your body with the nutrients it needs. Pills do not have phytochemicals, the non-nutrient compounds found in plant-derived foods that have biological activity in the body. Approximately 150 phytochemicals are found in foods along with the vitamins and minerals the body needs. Phytochemicals play a very important role in helping the body defend itself against cancer and cancer-causing agents, and probably many other things as well. An example of a known phytochemical is beta-carotene, a carotenoid. It is found in deeply pigmented fruits and vegetables, such as carrots, sweet potatoes, tomatoes, spinach, broccoli, cantaloupe, pumpkin, and apricots. Carotenoids act as antioxidants, reducing the risk of cancer. Read Antioxidants for more info.

So the best bet is to do what you were told as a child and, "eat your fruits and veggies!" Five servings a day is a great start. If you do supplement, be careful not to overdose. More of a "good" thing is not necessarily good for you. Besides being expensive, over-supplementing can be harmful to you. For more information, read What's the difference between vitamins and minerals? from the Go Ask Alice! Nutrition & Physical Activity archives.

Alice

Importance of eating breakfast

Dear Breakfast Boycotter,

Your brain (and central nervous system) run on glucose — that's the fuel you need to think, walk, talk, and carry on any and all activities. Let's say that the last time you eat something at night is at 10 or 11 PM (not optimal, just an example). The following day, you don't eat breakfast but wait until about noon or so to eat — you've gone thirteen or fourteen hours with nothing in your system. Your poor brain is surely deprived — and your body has to work extra hard to break down any stored carbohydrate or turn fat or protein into a usable form for your brain to function. That's a lot to ask for when you're sitting in a classroom, trying to concentrate on reading, or doing any other work. Eating breakfast has been proven (many times) to improve concentration, problem solving ability, mental performance, memory, and mood. You will certainly be at a disadvantage if your classmates have eaten breakfast and you've gone without. On average, they will think faster and clearer, and will have better recall than you. School or work can be tough enough without this extra added pressure.

Breakfast skippers also have a harder time fitting important nutrients into their diet. Many foods eaten at breakfast contain significant amounts of vitamins C and D, calcium, iron, and fiber.

Some people believe that skipping breakfast may help them lose weight. Not so! Skipping meals often leads to overeating later in the day. Becoming overhungry often leads to a lack of control and distorted satiety signals (meaning it's hard to determine when you're full). This can result in taking in more calories than if one had an appropriate breakfast. As a matter of fact, it's easier to control one's weight by eating smaller meals and snacks more frequently.

What if there's just no time in the morning to eat breakfast? There are plenty of items you can bring along with you to school or work. Carry a resealable bag of easy-to-eat whole grain cereal, or bring a yogurt or small box of skim milk, juice, or fruit. If you just can't stomach food in the morning, try to have a little something — such as some juice — and bring along a mid-morning snack. Other good portable items include: whole grain crackers, a hard boiled egg, cottage cheese, low-fat granola bars, or even a peanut butter sandwich. Single serving hot cereals, such as oatmeal, are handy — all you have to do is add hot water, available at most cafeterias or delis.

Whatever your choice, eat something. If you think you're doing fine with no breakfast, just try changing your tune for a week —you're likely to notice a difference. You will undoubtedly perform better with some fuel in your system, and, hopefully, become a breakfast believer.

Alice

Ginkgo biloba and physiological impotence?

Dear Reader,

Some people swear by Ginkgo biloba, calling it a miracle herb with the power to fix anything from Alzheimer's to erectile dysfunction. But what are the facts? Scientifically speaking the data is less clear.

According to available research, Ginkgo has been used effectively to improve cognitive function in patients with Alzheimer’s disease and dementia, as well as to improve memory in healthy adults and to treat peripheral vascular disease. Though it shows some potential with sexual dysfunction, the results have been mixed. In fact, Ginkgo’s effectiveness appears to be limited to relieving sexual dysfunction that is caused by selective serotonin reuptake inhibitors (SSRI) anti-depressants and not more generalized physiological causes. Some of ginkgo’s success with treating sexual dysfunction is believed to be the result of the placebo effect.

Though ginkgo is considered safe, there are some side effects such as headache, nausea, upset stomach, vomiting, and irritations around the mouth. Because of ginkgo’s ability to thin the blood, experts advise that you not take ginkgo if you are currently taking medication for diabetes, aspirin, ibuprofen or anticoagulant drugs such as heparin and warfarin. Doctors also advise caution to patients with bleeding disorders or those who are taking drugs, herbs (such as garlic, ginseng and red clover), or supplements that may increase the risk of bleeding.

Ginko biloba is usually sold as an extract because many of the plants parts, including its seeds, are considered poisonous and their consumption could lead to seizures and death. You may want to avoid these altogether.

Overall, Ginkgo could work for you either through the placebo effect or because of actual biochemical interactions — it just might not be your best bet. If you are interested in help with impotence you may want to speak with a health care provider. S/he can help you determine possible causes, the best treatment options, as well as answer any other questions you may have about Ginkgo biloba and its effects. Columbia students on the Morningside campus can make an appointment with Medical Services using Open Communicator or by calling 212-854-2284. Columbia students at the Medical Center can make an appointment with Student Health by calling 212-305-3400.

Alice

One cannot live on water alone

Dear Reader,

How much did you bet? It's time for your co-worker to pay up!

The human body can survive a surprisingly long time on water alone, but it is nowhere near six months. When the body is deprived of new fuel (i.e., food), it breaks into its energy reserves to keep going. The body stores energy in the form of carbohydrates, fats, and proteins.

After one day without food, the body will have used up its carbohydrates, which are stored as glycogen in liver and muscle cells. After that, it's on to the fat reserves. Your average Joe/Jane, weight-wise, has enough fat reserves to live for four to six weeks without food. After that, the body begins to use its protein reserves (basically, the body itself). Body proteins are used up at a much faster rate than fat, and you could really only get another two to three weeks out of protein. At that point, however, you can't really call it living since so much irreparable damage has been done to the body, including the brain.

Bottom line: an average person could live for about eight weeks on water alone, give or take about a week for an over- or underweight person, respectively.

Alice

Back-strengthening and stretching exercises

Dear Reader,

The lower back is an area that's commonly ignored in strength training, despite the fact that it can be a painful area for many people. Strengthening exercises, as well as stretching, can help prevent injury and pain in the lower back. It is important to focus on the lower back muscles as well as those in areas that support the lower back. These include the stomach, hip flexors, and hamstrings (back of the thigh).

It is always recommended to seek the advice of a health care provider before beginning any physical activity program, including back-strengthening and stretching exercises. If you have a condition that could be affected by physical activity, it is especially important to speak with your health care provider in advance.

Here are a few lower-back exercises to start with:

Front lying chest lift:

  • This is a body weight exercise that involves no equipment at all!
  • Lying face down, place your hands (palms down on the floor) next to and even with your chest.
  • Keeping your hips and thighs on the floor, lift your chest off the floor. Assisted slightly by your arms as you lift, your lower back muscles should be contracting.
  • Make sure the back of your head is in even alignment with your spine and avoid tilting your head up or down.
  • Pause briefly when your arms are straight and then return to starting position.
  • Build up to three sets of eight to twelve repetitions, taking short breaks between each set.

Double knee to chest stretch:

  • Lie on your back with knees bent, and pull both knees off the floor toward your chest, holding your legs behind the knees on the bottom part of your hamstrings.
  • This stretch can be done with both legs together or one at a time.

Figure-4 stretch:

  • Lying on your back, with your head on the floor or mat and right knee bent, pull your right knee towards your chest.
  • Then draw your knee across your body towards your left shoulder. Try to keep both shoulders on the floor or mat.
  • Repeat with your left leg.

Cat/Cow stretch:

  • On your hands and knees, let your back sag (push your chest towards the floor) while lifting up your head.
  • Alternate the stretch by arching your back and keeping your head down.
  • Lean back onto your heels and hold, keeping your head down and arms extended.

Abdominal muscle-strengthening stretch:

  • Lie face up with your knees bent and your hands placed loosely behind your head.
  • Slowly curl your upper back off the floor while pressing your lower back against the floor. You should feel your abdominal muscles contracting.
  • Pause briefly before returning to starting position. Try your best not to put pressure on your hands, or pull your head with your hands.
  • Keep your breathing coordinated: exhale on the way up, inhale on the way down.
  • It is important that you don't rush this exercise.

Hip flexor stretch (a.k.a. Runner's stretch):

  • Stretching your hip flexors can help alleviate stress to the lower spine.
  • Assume a lunge position, making sure that your front knee is directly over your foot and ankle, and that your knee isn’t past your toes when you look down (your knee will be in the form of a right angle).
  • With your weight supported by both hands touching the floor, press your hips towards the floor.
  • Repeat on the other leg.

Hamstring stretch (straight leg raise):

  • This exercise will also help reduce stress to the lower spine.
  • Lying on your back, bend your knees and keep both feet flat on the floor.
  • Raise and straighten your right leg without lifting your hips from the floor.
  • Support your leg and increase your range of motion by placing your hands below your knee, around the back of your leg, and gently drawing your leg towards your chest while keeping it straight.
  • Repeat with your left leg.

If you have access to a gym, the lower back machine allows you to increase resistance as you become stronger. Try the following resistance exercises two or three times per week on non-consecutive days:

  • Sit on the seat with your legs secured and upper back in contact with the roller pad.
  • Push the roller pad down towards the floor, contracting your lower back muscles (Your range of motion should be comfortable).
  • Pause briefly and return to starting position slowly. Keep your arms relaxed and your head in a neutral position.
  • Use a weight that allows you to complete two or three sets of eight to twelve repetitions.

You may stretch every day once you've warmed up your muscles. Stretch smoothly, as opposed to bouncing, which can cause injury. For maximum effectiveness, each stretch needs to be held for at least fifteen to thirty seconds. Some examples of lower back stretching exercises include:

You can also choose structured exercises for strengthening your back. Yoga, for instance, is an excellent form of back strengthening physical activity. Many of the suggested stretches listed above are a part of poses and movements performed during a yoga session. Swimming is another excellent exercise for your back, because the buoyancy of the water offers some support.

Also, take notice of your posture. What position do you spend most of your time in when you are sitting, standing, and walking? For example, are you sitting at a desk throughout the day? If so, be aware of your posture. Make sure the ergonomics of your work set up are optimal for your body. If you have freedom to play with your workspace, consider using a balance ball as a desk chair even for part of the day. Sitting on a ball demands your posture to be proper and many of your torso muscles to stay active.

Again, it is important that you speak with a health care provider before you begin a new physical activity regimen. If you are a Columbia student, you can make an appointment with Medical Services (Morningside) or the Student Health Service (CUMC).

Hope these exercises and stretches allow you to attain your physical activity goals!

Alice

August 20, 2012

515244
These exercises are perfect for ladies and gents, only they have to do it properly for at least three months to get a proper result . Then continue 4 days a week.
These exercises are perfect for ladies and gents, only they have to do it properly for at least three months to get a proper result . Then continue 4 days a week.

Managing high blood pressure through diet

Dear Reader,

Hypertension is known as the "silent killer" and is one of the most common diseases of the cardiovascular system. It is defined as a condition of sustained elevated pressure in the arteries of 140/90 or higher. In this case, 140 is the systolic pressure. Simply put, systolic pressure represents the blood pressure against the arteries while the heart is contracting or beating. The number 90 is the diastolic pressure, meaning the blood pressure while the heart is relaxing or between beats. People who are genetically sensitive to sodium experience high blood pressure from excesses in salt intake. People who are most likely to be salt sensitive include children of parents with hypertension, African Americans, and people over 50 years of age. It is important to keep in mind that not everyone is salt sensitive. As hypertension in the body becomes prolonged, the risk for heart failure, vascular disease, kidney (renal) failure, and stroke increases.

Although there has been no cause identified for hypertension in 90 percent of people, dietary factors have been shown to influence blood pressure. People with hypertension can use the following food guidelines:

Avoid foods high in sodium.
Sodium causes vasoconstriction, the narrowing of blood vessels. Therefore, the amount of space blood has to travel through decreases. This decrease creates an increase in the resistance the blood has to overcome. This increased resistance makes it more difficult for the arteries to expand with each beat of the heart, causing the internal pressure to rise. High sodium foods include processed meats, salted snack foods, cheeses, and canned foods.

Eat foods high in potassium.
Good dietary sources of potassium include bananas, potatoes, avocados, tomato juice, grapefruit juice, and acorn squash. Potassium helps maintain intracellular osmotic pressure, which is the force required to stop the flow of water across a membrane.

Limit adding salt to foods, particularly in restaurants.
Most foods, especially at restaurants, are already high in sodium.

Use salt substitutes.

Eat calcium and magnesium rich foods to help reduce blood pressure.
Food sources rich in calcium include low-fat milk, green beans, sardines with bones, broccoli, spinach, and tofu. Good sources of magnesium-rich foods include any legumes and seeds, such as navy beans and sunflower seeds.

Lower saturated fat intake.
Saturated fat increases the level of low density lipoproteins (LDL), which tend to stick to the sides of the arterial wall. This deposit of fat is known as atherosclerosis. Atherosclerosis begins with the accumulation of fatty streaks on the inner arterial walls. When this fatty buildup enlarges and becomes hardened with minerals, such as calcium, it forms plaque. Plaque stiffens the arteries and narrows the passages through them. Thus, blood pressure rises. This rise in blood pressure is due to the arteries' lack of elasticity.

Hypertension can also be treated with drugs, including diuretics, beta blockers, calcium channel blockers, and ACE inhibitors. Talk with your health care provider to see what treatment is best for you, if you need it.

According to a Harvard research study, the DASH! Diet could be another possible way to decrease blood pressure. DASH! stands for Dietary Approaches to Stop Hypertension. The Dash trials began with 459 adults with systolic pressure of less than 160 and diastolic pressure between 80 and 95. The Dash study randomly assigned people to one of three diets for eight weeks. The first diet was the Control Diet. This diet had levels of fat and cholesterol that matched the average American's diet. It had lower than average levels of potassium, magnesium, and calcium. The other two groups were divided into a "Fruit and Vegetable Diet" and a "Combination Diet." The Fruit and Vegetable group matched the control group in fat, saturated fat, cholesterol, and protein. However, the difference was that this diet had more potassium and magnesium. The fruit and vegetable diet reduced systolic blood pressure 2.8 mm Hg more than the control diet. It also reduced diastolic blood pressure 1.1 mm Hg more than the control. The Combination Diet had less total fat, saturated fat, and cholesterol than the fruit and vegetable and control diets. The combination diet, rich in fruits, vegetables, and low-fat dairy products, also had more potassium, magnesium, calcium, fiber, and protein. This combination diet reduced systolic blood pressure 5.5 mm Hg more than the control diet. It also reduced diastolic blood pressure 3.0 mm Hg more than the control diet.

To adapt the Dash Diet into your lifestyle, follow these guidelines:

  • Make gradual changes in your eating patterns.
  • Center your meal around carbohydrates, such as pastas, rice, beans, or vegetables.
  • Increase consumption of fruits and vegetables.
  • Treat meat as one part of the whole meal.
  • Decrease use of fat.

For example, total number of servings in a 2,000 calorie per day menu would look like this:

Food Group Servings
Grains 8
Vegetables 4
Fruits 5
Dairy Foods 3
Meats, Poultry, & Fish 2
Nuts, Legumes, & Seeds 1
Fats & Oils 2.5

For more info on the Dash Diet, you can go to the Harvard Medical School Family Health Guide website.

Finally, weight loss is recommended if you are overweight. Obesity can worsen hypertension. Extra adipose tissue means miles of extra capillaries through which the blood must be pumped. Weight loss can be accomplished through aerobic activity. Aerobic exercise will utilize fat stored in the body. This, along with weight training, will increase your muscle mass, which, in turn, will raise your metabolic rate. Therefore, you will expend more calories throughout the day.

Alice
[Material adapted from:

Marieb, Elaine N. Human Anatomy and Physiology. CA: The Benjamin/Cummings Publishing Co., 1997: p. 710.

Whitney, Eleanor and Sharon Rolfes, eds. Understanding Nutrition. Minneapolis/St. Paul: West Publishing Co., 1996.]


Best time of day to exercise?

Dear Early bird exerciser,

The best time to exercise is the time that's right for you. Morning workouts really get some people going, release endorphins, and enhance mood. If you enjoy starting your day with a workout, or find that it's the only time you can fit it into your schedule, stick with it. Others find afternoon or evening workouts productive and stress-relieving. When we wake up, our body temperature and blood sugar levels are low, so our muscles aren't as "loose" as later in the day. In a perfect world, our muscles are warmer and fueled by a few meals (hopefully) later, well after we awake.

There isn't really a "simple" answer to your second query. It will be helpful, though, to ask yourself the following questions: How hard do you work out (intensity)? How long are your sessions (duration)? What are your exercise activities? How soon after you awake do you begin exercising? Your answers are important in determining what may enhance your performance.

For some people, exercising with no fuel (food) beforehand may cause lightheadedness, dizziness, and early fatigue. Research shows that eating before exercise, as opposed to exercising on an empty stomach, improves athletic performance. If you have three hours until your workout, have a normal breakfast. However, if you're going straight to a workout after waking up, here are a few suggestions:

  • If your exercise session is less than an hour, just snack on any foods that are easy to digest, such as bread, crackers, or a banana.
  • If your session is one hour or longer, get up a little earlier and have something small to eat — perhaps around 250 - 300 calories — such as toast and fruit or a small bowl of cereal and skim milk.
  • Drinking some water before and during exercise is important for hydration.

If you eat before exercising, make sure you allow your body some time to digest and absorb the food. During digestion, our bodies send blood to the stomach to help out with this process. When we exercise, our muscles need the blood flow, so our stomach becomes a second class citizen and digestion is slowed. If too much food is in the stomach while we're exercising, we may be uncomfortable.

Also take into account the type of food you eat and the activities you do. Some people tolerate liquids more easily because they leave the stomach more quickly than solid food. Some exercisers, such as runners, for example, would prefer not to have the internal "sloshing" around that liquids may cause.

General guidelines for eating before exercising are:

  • Three or four hours before exercising, a large meal is fine (500 calories or more).
  • Two or three hours beforehand, a smaller meal is suitable (400 - 500 calories).
  • One or two hours before, a liquid meal is appropriate (300 - 400 calories).
  • With less than one hour, a small snack will do (200 - 300 calories).

In addition, people tolerate foods differently, and the composition of the food matters. Fats stay in the stomach longest, followed by protein and high fiber carbohydrate, then low fiber complex carbohydrates, and finally simple sugars, which are absorbed fastest.

Sugary foods, such as sodas and candy, are absorbed quickly by the body and produce a sugar high within an hour of a workout. Along with a quick "sugar high" comes a quick "sugar low." People who eat sugar 15 - 30 minutes before exercising may experience a "low," with lightheadedness and fatigue, during their workout. If you feel that you absolutely must have juice or some sugary snack before exercising, have it only five or ten minutes before you begin. This way, there isn't enough time for your body to secrete insulin, a hormone which lowers blood sugar, causing fatiguing symptoms. Since everyone reacts differently, try various strategies to determine what helps you the most. No matter what, drink water before, during, and after exercise. And, have breakfast afterwards, especially if you haven't had anything to eat earlier, since this will replace glycogen stores and will keep you going all morning long.

For more information about staying active while at Columbia, check out CU Move, a physical activity initiative open to all Columbia students, faculty, alumni, and staff. CUMove posts updates regularly and also sends out monthly CU Move emails. For more frequent updates, “Like” CUMove on Facebook. Keep moving!

Alice

What is chondromalacia?

Dear Reader,

Under the knee cap and covering the ends of the femur (thigh bone) and tibia (shin bone) is a sort of natural shock absorber made of cartilage. This shock absorber does not come with a lifetime guarantee; wear and tear over the years can result in a loss of mass of the shock absorbing cartilage. Once some of this cartilage has degenerated, the knee obviously cannot absorb or handle shock from running, for example, as well as it could before. This condition is referred to as "chondromalacia patella."

Technically, chondromalacia is an overuse injury that causes a dull, aching pain under and around the knee cap. Climbing stairs, walking up hills, and doing anything that involves a fair amount of running can all become painful activities for someone with chondromalacia patella. This knee condition is fairly common among runners — by some estimates, almost 30 percent of runners develop this condition. Skiers, cyclists, and soccer players also have a higher risk for chondromalacia patella. The tendency to develop chondromalacia patella also seems to run in families.

Everyday that you get up is a day of stress as far as your knees are concerned. Walking around, climbing stairs, running, dancing, waiting in lines — all of these activities put some amount of stress on the knees. As far as joints go, the knee is the largest one in the body; it's also multi-talented, acting as a hinge, a lever, and/or shock absorber at any given time. For support, the knees rely almost entirely on soft tissue (ligaments, tendons, and muscles), which isn't always the most reliable. It's no wonder that knee pain and injury are so common!

You can do some things to prevent (further) knee injury and pain. Always wear good, supportive shoes that aren't worn out, especially when you exercise. Have a health care provider check your feet to make sure that they aren't contributing to a misalignment of your body that puts undue stress on one knee over the other. Or, if you get a chance to see a physical therapist, ask her/him to check the way you walk. If you ride a bike regularly, make sure that your seat is up high enough so that your knee is only slightly bent at the bottom of a pedal stroke. If you're a runner, avoid running on uneven surfaces as much as possible to lower your risk of falling and/or twisting your knee.

If, after every time you engage in a certain sport, say racquetball or running, you experience a great deal of knee pain, you might want to take a break from that particular activity and try different options that won't aggravate your knees (hopefully). A few "easy on the knees" sports are swimming, slow jogging, walking, and cross-country skiing. If you choose swimming, be aware that strokes involving the frog kick will put more stress on your knees than those that use a straight-leg, flutter kick (such as freestyle and backstroke). Any sport that requires deep knee bends and/or twisting at the knee causes knee pain most often.

It's extremely important to strengthen your leg muscles, especially those that support your knee, primarily the quadriceps; but, it's best to work on the leg as a whole so as not to favor one muscle group over another (this, too, can lead to injury). Remember, the knee doesn't have much of a support system, so you need to do all you can to build up what it does have. Ask your health care provider to show you some strength building exercises you can do. Perhaps you can get a referral to see a physical therapist or orthopedist to learn how to build up strength and reduce any pain. Keep those joints happy!

Alice

May 19, 2004

20567

Dear Alice,

I suffered from chondromalacia for years. Arthroscopic surgery a few years ago helped, but what did the trick was developing the muscles that hold my knee in place and allow...


Dear Alice,

I suffered from chondromalacia for years. Arthroscopic surgery a few years ago helped, but what did the trick was developing the muscles that hold my knee in place and allow them to track properly. Spinning classes 2 - 3x/week for the last two years *really* helped with this. I am also sure to stretch it well, including the ITB. Anyone with chondromalacia should see a good sports- and fitness-focused physical therapist, and with their blessing, try spinning!

January 31, 2003

20468

ALICE,

I JUST WANTED TO SAY THANK YOU FOR YOUR PAGE. I HAVE HAD KNEEE PAIN FOR OVER TWO YEARS AND FINALLY GAVE IN AND WENT TO THE DOCTOR. I HAVE CHONDROMALACIA AND DID NOT KNOW WHAT IT...


ALICE,

I JUST WANTED TO SAY THANK YOU FOR YOUR PAGE. I HAVE HAD KNEEE PAIN FOR OVER TWO YEARS AND FINALLY GAVE IN AND WENT TO THE DOCTOR. I HAVE CHONDROMALACIA AND DID NOT KNOW WHAT IT MEANT. SO THANKS FOR THE INFO. I WAS A RUNNER AND I AM NOT READY TO GIVE THAT UP, SO I AM DOING MUCH RESEARCH NOW. AGAIN, THANKS FOR YOUR PAGE AND INFO.

DEE

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