Practice
PATIENT HANDOUTS
Orthopedic Disorders	Home

ARTHRITIS

1. Moderate regular exercise (walking, cycling, swimming) reduces pain and arrests joint deterioration.

2. Cold gel packs reduces pain. These are reusuable.

3. Correct food. Therapeutic fast, followed by monitored reintroduction of foods to identify allergenic foods will help isolate problematic foods. (e.g. wheat, corn, milk products, tomatoes, potatoes, pepper).

Back Exercises

EASY EXERCISES FOR STRENGTHENING YOUR BACK

The best protection against a back injury is strengthening
the back and stomach muscles, as you can do with these four
easy exercises:
 
* FLEXED-KNEE SIT-UPS. Lie on your back, with knees bent and
arms at your side. Sit up slowly by rolling forward,
starting with the head.
 
* BENT-KNEE LEG LIFTS. In the same position as the sit-ups,
bring one knee as close as you can to your chest, while
extending the other leg. Alternate the legs.
 
* KNEE-CHEST LEG LIFTS. Work from the bent-knee sit-up
position but put a small pillow under your head. Use your
hands to bring both knees up to the chest, tighten the
stomach muscles and hold that position for a count of ten.
 
* BACK FLATTENING. Lie on your back, flex the knees and put
your arms above your head. Tighten your stomach and buttock
muscles, pressing the lower back hard against the floor.
Hold this position for a count of ten. Relax and repeat.
 
Remember not to overdo it (soreness is your body's signal to
you to cut back) and never do these exercises with the legs
straight. If you have back trouble, consult your doctor
before starting this or any exercise program.
 
Source: "American Journal of Nursing," New York (adapted)

Back Stretching

Hanging around the house might help you eliminate back pain
caused by overworked muscles.
 
Consider buying a pull-up bar at your nearest sporting goods
store. Install it in the most appropriate location.Then,
when your back hurts, hang by your hands from the bar. Hang
for at least 10 seconds, repeating several times.
 
This simple stretching exercise can help relax your
midsection, align your spine and relieve back pain.
 
Bone Loss - How To Stop

Avoid painful bone loss in the future. Osteoporosis, a bone- destroying disease, doesn't just affect women. Be sure to exercise, and take your calcium and supplements daily. 
Make sure you get 1,000 mg of calcium each day (1,500 if you are over the age of 50), take 400 I.U. of vitamin D each day (vitamin D helps your body absorb calcium) and exercise five times a week. 
Source: "Prevention" Magazine June 1999 

Foot care
If you're like most people, you don't pay enough attention to footwear and foot care.
Most of us walk around in shoes that have lost their shape and need new heels. We tend not to realize that the "savings" we realize from neglecting what we walk in, represents a false economy.
 Posture, spinal problems and back pain can all be affected by shoes.
* Regularly reheel your shoes, especially if you wear out the heels at an angle.
* If you do wear out your heels at an angle, consider using "leveler" inserts, sold inexpensively at shoe repair shops.
* Buy cushion inserts and replace them when they wear out.
* Use shoe trees when storing your shoes, to help them keep their shape.
* Rotate regularly between different pairs of shoes.
* Select footwear appropriate for the activity.
* Consult with a podiatrist (foot doctor) or at least your primary care physician, if you experience any problems with your feet.

Repetitive Strain Injuries (RSI)
For workers who spend most of the day sitting at a desk in front of a computer, repetitive stress injuries are now among the most common on-the-job hazards. You can stay healthy by following some basic ergonomic principles:
* Keep everything you need in easy reach - frequent work in a semicircle within 10 inches of your body, occasional work within 20 inches.
* Work at proper heights. Arrange your work area so that you can work with your elbows at an angle of about 90 degrees. Minimize forward and sideways reaches to below shoulder-level height.
* Reduce excessive forces. Use tools that are task-specific, fit the hand and distribute forces throughout the hand.
* Work in good postures. Avoid bending and twisting while lifting or placing objects. Turn with your whole body, rather than with the torso alone. Keep the spine balanced and the wrists as straight as possible while working.
* Reduce excessive repetition and rapid arm or hand movements.

Please look after your body if you're in the computer field. 

* Is your monitor at head height? 
You should look straight into it, to prevent you from slouching with your neck or back to unconsciously adjust your head to your monitor.

* Are your wrists straight as you type? 
Are they supported? Keeping your wrists straight may make an immediate difference in the amount of tension in your arm. A wrist support doesn't have to be anything fancy, a rolled up towel can be more than enough. Support your wrist when you use the mouse, too.

* Are your limbs at 90% angles? 
Elbows, knees and hips are happiest at right angles.

* Do you rest your eyes and move them around? 
The muscles that move the eyeball can atrophy if you look straight ahead at a computer screen all
day. Take frequent breaks, and look around - I'm sure you can find a reason to roll your eyes!

* Do you get up and walk around at least once an hour? 
Stretching out and moving about will keep you much more mentally alert. I set a timer, and try to stand up every 20 minutes.

* Is your screen resolution large enough? 
Do you squint at the screen? Even though I've got a decent monitor, I use the lowest resolution
possible - 640 * 480. I find this much easier on my eyes.

* Is your back supported and straight? 
Your chair and environment should support your body, since humans really aren't built for using
computers. We need to help our bodies compensate for this 'new' task.

SPORTS INJURY - TREAT IT WITH "R.I.C.E."

The next time you get a sports injury, remember RICE, an
acronym that stands for Rest, Ice, Compression and Elevation:
 
* REST means taking a break from exercise or any movement that
might stress the injured area. Minor injuries should be rested
for a day or two. More severe injuries need even longer.
Returning to your exercise routine too soon will only cause the
problem to worsen.
 
* ICE the affected area. Ice reduces pain, limits the swelling
and bleeding and encourages quick healing. Wrap an ice pack (or
even a bag of frozen peas) in a towel, to avoid direct contact
with the skin.
 
* COMPRESS the injury with a stretch bandage. Wrap it just tight
enough to support the injured area comfortably.
 
* ELEVATE the limb. Keep the injured part above the level of the
heart, if possible, or at least higher than the hips. This will
limit the swelling and also prevent movement of the injured
area.
 
Be patient, giving your body time to heal. After the pain has
gone, work out at a low level of exertion. This stimulates blood
flow, warming the muscles and making you feel better.

Tennis Elbow
You don't have to be a tennis player to suffer from tennis
elbow. Everyone who works with their hands on a regular
basis stands the chance of developing pain near the elbow
(usually on the outside of the forearm, just below the bend).
Prevent it by following preventative tips:
 
* Lift objects with your palms facing toward your body.
* Do strengthening exercises. With palms down and elbows
bent, flex your hands up and down. You can also do this
exercise with weights.
* Stretch your muscles before engaging in strenuous
activities. Grab the top of your fingers with the opposite
hand and pull them gently toward your body.
Source: "Do-it-Yourself Health" by Time-Life (adapted)